糖尿病人配合飲食控制對血糖及血脂之影響

Effects of Dietary Adherence on Blood Glucose and Triglyceride Control in Diabetic Patients

黃淑俐(Shu-Li Huang) ； 陳羿璇(I-Shiuan Chen) ； 呂菁(Ching Lu) ； 楊宏智(Hong-Jyh Yang) ； 張然舜(Jan-Shun Chang)

《臺灣營養學會雜誌》 41卷3期 (2016/09) Pp. 85-92

https://doi.org/10.6691/NSJ.201609_41(3).0002

摘要

本研究的目的在探討門診糖尿病人，是否配合飲食控制和臨床指標的關係。經由隨機取樣方式選擇門診糖尿病人，以非介入性、橫斷性的流行病學調查，進行面對面的問卷訪談，共收達447份有效問卷。以病人主觀勾選飲食控制為其治療糖尿病的方式，比較有無飲食控制的病人，在糖化血色素、空腹血糖、三酸甘油酯、高密度膽固醇、低密度膽固醇、總膽固醇、肌酸酐、尿蛋白和飲食配合度的差異。有飲食控制者83名，無飲食控制者364名，後者女性較多（p =0.000）、年齡較長（p =0.016）、糖尿病罹病年數較長（p =0.000）、合併較多慢性病（p =0.008）、較多人使用胰島素治療（p =0.033），糖化血色素（p =0.000）和三酸甘油酯（p =0.008）較高；身體質量指數、腰圍、飯前血糖、總膽固醇、高密度膽固醇、低密度膽固醇、肌酐酸、蛋白尿均無顯著差異。有飲食控制的病人較能遵從每天三餐定時定量（p =0.004）、每天吃1.5～4碗全穀根莖類（p =0.001）、每天吃3種以上的新鮮蔬菜（p =0.047）、每天吃2種以上的水果（p =0.015）、每天吃豆、魚、肉、蛋類食品（p =0.049）。本研究顯示，大部份門診糖尿病人（81%），承認並未飲食控制，此族群之血糖和血脂控制不如有飲食控制的病人，有飲食控制的病人，較能配合遵循均衡飲食的建議。

關鍵字

糖尿病 ； 均衡飲食 ； 飲食配合度 ； 血糖控制 ； 糖化血色素 ； 三酸甘油酯

並列摘要

The aim of this study was to explore the effects of adherence to the recommended diet on the clinical parameters in patients with diabetes. This was a cross-sectional study with randomized sampling. Data were collected by face-to-face interviews with a food frequency questionnaire in a regional teaching hospital in the Hsinchu area. In total, 447 outpatients with diabetes participated in the study; 364 (81%) of them did not adhere to the recommended diet (NAR group), while 83 (19%) of them adhered to recommended diet (AR group). Female (p = 0.000), older participants (p = 0.016), and those with a longer duration of diabetes (p = 0.000), with more comorbidities (p = 0.008), and with insulin therapy (p = 0.033) were more common in the NAR group than those in the AR group. Patients in the AR group had lower glycated hemoglobin (HbA1C)(p = 0.000) and triglyceride (p = 0.008) levels, and they also followed the fixed amount of food and time schedule of meals (p = 0.004), daily intake of 1.5～4 bowls whole-grain staple foods (p = 0.001), more than three kinds of fresh vegetables (p = 0.047), more than two kinds of fruits (p = 0.015), and the proper amounts of meat and beans (p = 0.049). Our results showed that most diabetic patients (81%) reported that they did not adhere to recommended diet had higher HbA1C and triglyceride levels. Patients with dietary adherence were more likely to meet the recommendations of a healthy, balanced diet.

並列關鍵字

diabetes ； balanced diet ； dietary adherence ； glycemic control ； HbA1C ； Triglyceride