探討糖尿病衛教介入對門診第2型糖尿病患血糖控制與認知功能之影響

高胰島素血症及胰島素抗性對老年人認知功能退化是重要危險因子，老年人糖尿病控制不佳會加速認知功能退化。本篇為1年介入性研究，於內分泌科門診進行收案，探討第2型糖尿病患接受營養教育介入後血糖控制及認知功能改變是否有正向影響。招募對象為50至70歲且罹病年齡至少10年以上之第2型糖尿病患，依是否接受糖尿病衛教分成實驗組（26名）及對照組（12名）。介入前後皆蒐集3日飲食紀錄、飲食行為及認知問卷調查、生化數值及認知功能測驗（Mini-Mental Status Examination, MMSE）。實驗組經過1年糖尿病衛教介入，包含營養諮詢、病友會及個別指導。結果顯示：介入後兩組的生化數值、熱量攝取及MMSE分數皆無顯著差異，但飲食認知問卷分數實驗組顯著較對照組高（p＝0.01）。結論：糖尿病衛教可顯著改善飲食認知觀念，但需要延長介入時間及排除干擾因子以釐清衛教對於血糖、血脂之影響。

關鍵字

第2型糖尿病；血糖控制；認知功能；營養教育；飲食認知及行為

並列摘要

Hyperinsulinemia, insulin resistance and poor glucose control are among the risk factors of the cognitive decline among elderly adults with diabetes mellitus (DM). This prospective cohort study recruited participants aged from 50 to 70 years, and had type 2 DM for at least 10 years in the Department of Endocrinology. Two groups, the dietitian-coached (DC) group (n=26) and control group (n=12) were assigned. The DC group received diabetes educational intervention (DEI) every 3 months and group health education. Dietary records, diet questionnaire, clinical measurements, and Mini-Mental State Examination (MMSE) were collected at the baseline and after one year of intervention. The results showed that there were no significant differences in blood glucose, blood lipid, and MMSE score between the two groups after intervention. However, the dietary knowledge score was significantly higher in the DC group. We concluded that the DEI is helpful to the dietary concept in lipid con trol.

並列關鍵字

type 2 diabetes mellitus ； glycemic control ； cognitive function ； nutrition education ； dietary knowledge and practices

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