- 學位論文
積極營養教育介入對第2型糖尿病患胰島素阻抗性及體重變化之影響
Active intervention of nutritional education on the insulin resistance and body weight of type 2 diabetes patients
摘要
糖尿病是目前國人常見的一種慢性病，民國97 年至99 年居十大死因第五位。糖尿病雖不能治癒，但可以經由積極的血糖控制，降低併發症的發生。 第2 型糖尿病的特點是血糖高，在周邊組織有胰島素阻抗性現象，本研究針對肥胖體位的第2 型糖尿病患，進行積極的減重營養教育，期望減輕至合理體重，幫助血糖控制，此外，同時觀察體重之變化對胰島素阻抗性之影響。 本研究將受試者分成實驗組及對照組，實驗組接受積極營養教育介入，而對照組接受糖尿病共同照護網之常規營養教育。本研究記錄受試者基本資料、疾病史、生活習慣及飲食內容，在營養教育介入的第0、3、6 月分別測定體位及血液生化值。 全程參與實驗組之受試者共有25 人(男性13 位、女性12 位)；對照組共有30 人(男性17 位、女性13 位)，全部受試者年齡介於30~79 歲。實驗組經6個月後，體重顯著減輕0.9 公斤(P≦0.05)，體脂肪顯著降低2.28%( P≦0.05) ，臀圍顯著減少4.35 公分(P≦0.05) ，舒張壓顯著降低5.07mmHg(P≦0.05)，糖化血色素顯著減少0.36%(P≦0.05)，胰島素阻抗性(HOMA-IR)也顯著降低(P≦0.05)。與對照組比較，實驗組胰島素阻抗性的減少與體重之降低呈 正相關 (r=0.10) 。
並列摘要
Diabetes is a common chronic disease in Taiwan, and now it ranks at the 5th leading cause of death. Although diabetes cannot be cured, it the incidence of complications can be decreased by positive blood glucose control. Type 2 diabetes has characteristic of high blood glucose with the phenomenon of insulin resistance in the peripheral tissues. This study was focused on type 2 diabetes patients with obesity by conducting education of active losing weight to help blood sugar control. In addition, observed the change of body weight and its effect on insulin resistance. In this study, the subjects were divided into experimental group and control group. Experimental group received active nutrition education. Control group received routine hospital nutrition education of Diabetic Caring Network. When subjects were enrolled, the basic information, medical history, habits, and diet recall were collected. After 0, 3, and 6 months of nutritional intervention, anthropometric measurements and blood biochemical parameters were determined. There were 25 people (13 males and 12 females) in experimental group.Control group included 30 people (17 males and 13females).The age was at the range of 30 to 79 years old. After 6 months, for experimental group, body weight obviously reduced 0.9 kg (P≦0.05), and body fat ratio decreased 2.28% (P≦0.05), hip circumference reduced 4.35 cm (P≦0.05), diastolic pressure decreased 5.07mmHg, HbA1C (Glycated hemoglobin) reduced 0.36%, and HOMA-IR (homeostasis model assessment of insulin resistance) also reduced (P≦0.05). In contrast to control group, the reduction of insulin resistance in experiment group showed a positive correlation with body weight (r＝0.10).