南投縣某醫院糖尿病患營養診斷相關性分析

Nutrition Problems of Diabetic Patients in Nantou County

蔡秀雯(Hsiu-Wen Tsai) ； 洪弘昌(Hung-Chang Hung) ； 蔡玉思(Yu-sz Tsai) ； 奚進富(Chin-Fu Hsi) ； 林以勤(Yi-Chin Lin) ； 劉凱莉(Kaili Liu) ； 呂昂衛(Ang-Wei Lu) ； 黃淑敏(Shu-Ming Huang)

《醫學與健康期刊》 9卷2期 (2020/07) Pp. 51-62

摘要

目的：本研究以國際膳食與營養術語（International Dietetics and Nutrition Terminology, IDNT）的營養診斷（nutrition diagnosis），探討糖尿病患的營養問題及與疾病相關檢驗值間相關性。方法：針對30－90歲門診糖尿病營養紀錄共306位。以立意取樣方式，收集病患基本資料、營養診斷、疾病相關檢驗評量進行統計及相關性分析。結果：本研究306位糖尿病病患最常見的營養問題分別為醣類攝取過多、脂肪攝取過多與礦物質攝取過多（鈉）有23.44%、14.21%與8.21%個案有此營養診斷。此外，15.71%病患為目前沒有營養診斷。醣類攝取過多的營養診斷與BMI＞24有顯著差異（p＜0.001），但與醣化血色素＞7無顯著差異。結論：本研究結果顯示，糖尿病患脂肪及醣類均有攝取過量的營養診斷問題。醣類攝取過多的病患雖血糖控制正常，但仍有肥胖問題。故針對病患之根本問題，營養師應加強衛教體重控制的重要性，並給予個別化的飲食計畫及措施，使用營養診斷可以強化醫療團隊的溝通。

關鍵字

糖尿病 ； 營養診斷 ； 居住地 ； 生化指數

並列摘要

Objectives. This study aimed to evaluate the nutrition of diagnosis among Nantou individuals with type 2 diabetes in Nantou, Taiwan, and identify differences in dietary problems using through Nutrition Care Process (NCP) and International Dietetics and Nutrition Terminology (IDNT) NCP of IDNT. Methods. Nutritional diagnoses were surveyed and analyzed in 306 patients with type 2 diabetes, aged 30-90 years old from outpatient clinics in Nantou hospital. Results. The most common nutrition abnormalities in Nantou hospital were excessive carbohydrate intake (23.44%), excessive fat intake (14.21%), excessive sodium intake (8.21%), and no nutrition diagnosis (15.71%). There were no differences in nutritional intake between those living in urban and rural areas. Excessive carbohydrate intake was positively associated with BMI＞24 but not HbA1c＞7. Conclusion. While medicine may be used to control HBA1C levels, it cannot be used to effectively control obesity. Obesity can lead to cardiovascular disease and other complications. Therefore, patients who are obese patient need to be educated about the benefits of body weight control. Nutritional diagnosis results can facilitate communication among patients and the team caring for them.

並列關鍵字

Diabetes ； Nutrition diagnosis ； Life area ； Biomarkers

參考文獻

International Diabetes Federation: Diabetes Atlas eighth Edition. http://diabetesatlas.org/resources/2017-atlas.html. Accessed 5/4/2018.

衛生福利部：107年度全民健康保險醫療統計年報。https://www.nhi.gov.tw/Content_List.aspx?n=D529CAC4D8F8E77B&topn=23C660CAACAA159D。引用11/27/2019。Ministry of Health and Welfare：2018 National Health Insurance Annual Statistical. Available from: https://www.nhi.gov.tw/Content_List.aspx?n=D529CAC4D8F8E77B&topn=23C660CAACAA159D。Accessed Nov 27, 2019. [In Chinese]

衛生福利部：105年死因統計結果分析。https://www.mohw.gov.tw/cp-16-33598-1.html。引用4/2/2018。Ministry of Health and Welfare: 2016 Cause of Death Statistics. Available from: https://www.mohw.gov.tw/cp16-33598-1.html. Accessed April 2, 2018. [In Chinese]

American Diabetes Association: Lifestyle Management Standards of Medical Care in Diabetes. http://care.diabetesjournals.org/content/41/Supplement_1/S38. Accessed 5/4/2018.

Chika Horikawa: Dietary intake in Japanese patients with type 2 diabetes: Analysis from Japan Diabetes Complications Study. J Diabetes Invest 2014;5:176-87.