醫院提供營養衛教對第2型糖尿病患者飲食行為控制及臨床血液生化值之影響

Effect of Nutrition Education on Dietary Behavioral Control and Clinical Blood Biochemical Values of Patients with Type 2 Diabetes Mellitus

林櫻子(Ying-Tzu Lin) ； 劉欣怡(Hsin-Yi Liu) ； 莊筱婷(Hsiao-Ting Juang) ； 劉珍芳(Jen-Fang Liu)

《臺灣營養學會雜誌》 42卷1期 (2018/03) Pp. 1-10

https://doi.org/10.6691/NSJ.201803_42(1).0001

摘要

糖尿病照護需靠藥物、良好的生活習慣及健康的飲食行為。在台灣，糖尿病患者可加入糖尿病共同照護網，獲得醫師、糖尿病衛教師及營養師的共同照護。本研究採病歷回溯方式將北部某醫學中心糖尿病共同照護網收案2年以上，且固定每年接受4次營養衛教的第2型糖尿病患者，收集個案多次飲食行為評估記錄，給予正向分數量化，分數越高表示飲食行為越佳。共納入2966位個案，依第一次飲食行為評估分數分為2組（＞16之高分組與≤16之低分組），結果顯示接受越多次營養衛教，可改善第2型糖尿病患者的飲食行為，特別是對於飲食行為控制較差的低分組，其飲食行為分數顯著增加（14.3 ± 1.8增為17.5 ± 1.5），而飲食行為控制較佳的高分組在身體質量指數、血液生化值及舒張壓皆顯著較低分組佳，兩組在兩年後的醣化血色素、飯後血糖、總膽固醇、低密度脂蛋白及舒張壓也皆有顯著改善。因此醫院提供營養衛教可改善第2型糖尿病患者的飲食行為，而良好的飲食行為則可改善第2型糖尿病患者臨床血液生化值之表現。

關鍵字

第2型糖尿病 ； 糖尿病共同照護網 ； 飲食行為 ； 營養衛教 ； 血液生化值

並列摘要

Diabetes care requires comprehensive treatment, including medicine, a good lifestyle, and healthy eating habits. In Taiwan, diabetic patients treated at medical institutions can participate in a diabetes shared care program (DSCP) and receive integrated care from a physician, diabetes educator, and dietitian. In this prospective study, we collected 2-year dietary behavioral records of 2966 patients in a DSCP at a medical center in northern Taiwan. These subjects received nutritional education four times per year. We quantified the dietary behavioral records, and if the score was higher, the dietary behavior was better. According to scores at the first dietary behavior assessment, all participants were divided into two groups (a high-score group of ＞ 16 and a low-score group of ≤16). Results showed that nutritional education significantly increased the scores of dietary behaviors of the low-score group (from 14.3 ±1.8 to 17.5 ± 1.5). Blood biochemical values, the body-mass index, and diastolic blood pressure (DBP) of the high-score group were also significantly better. After 2 years, hemoglobin A_1C, post cibum, total cholesterol, low-density lipoprotein-cholesterol, and DBP in both groups had significantly improved. In conclusion, regular nutritional education can improve dietary behaviors of type 2 diabetic patients and contribute to better clinical outcomes.

並列關鍵字

type 2 diabetes mellitus ； diabetes shared care program ； dietary behavior ； nutrition education ； blood biochemical values