含高膳食纖維的管灌配方對糖尿病患營養狀況之影響

國人糖尿病盛行率逐年增加，且罹患人口年齡層也有年輕化的趨勢，飲食在糖尿病治療中與藥物、運動同樣重要。過去研究指出攝取膳食纖維具有延緩餐後血糖、改善血脂肪和降低C-反應蛋白的好處。本研究主要目的在探討對於台灣長期照顧機構中，使用管灌飲食且空腹血糖値異常的住民，使用含高膳食纖維的管灌營養品，對於血糖控制及營養狀況的影響。本研究最後完成連續介入12週的受試者一共有30位，其中男性13名，女性17名，研究期間收集受試者第0週與第12週的血液進行生化檢驗。結果顯示，在介入12週後，受試者的前白蛋白由21.74±6.53 mg/dL顯著增加至25.52±6.72 mg/dL(p＜0.01)，TIBC由270.23±72.66 ug/dL顯著增加至305.07±75.29 ug/dL(p＜0.05)，每日熱量攝取由1440.00±257.78 kcal/day顯著增加至1503.33±191.16 kcal/day(p＜0.01)，膳食纖維攝取由7.60±4.35 g/day顯著增加至22.05±2.57g/day(p＜0.01)，表示在介入含高膳食纖維的管灌配方12週後，受試者的營養狀況有獲得改善。另外，在受試者熱量攝取增加且營養狀況改善下空腹血糖、糖化血色素、胰島素及HOMA-IR並無顯著變化。

關鍵字

膳食纖維；糖尿病；糖化血色素； C-反應蛋白；管灌營養品； HOMA-IR index

並列摘要

The prevalence of diabetes is increasing every year and there is a growing trend of people suffering from diabetes at a younger age in Taiwan. Along with medication and exercise, diet is critically important in the management of diabetes. Numerous studies have shown that dietary fiber provides benefits including delaying postprandial blood glucose elevation and decreasing serum lipid and C-reactive protein (CRP). The aim of this study was to investigate the effect of tube feeding formula containing high dietary fiber on blood sugar control and nutritional status in tube-fed nursing home residents with impaired fasting glucose. A total number of 30 participants (13 male and 17 female) have completed a 12-week dietary intervention and underwent blood biochemical tests at baseline and 12 weeks. Results showed significant increases in prealbumin levels (from 21.74±6.53 mg/dL to 25.52±6.72 mg/dL; p＜0.01), total iron-binding capacity (TIBC) (from 270.23±72.66 ug/dL to 305.07±75.29 ug/dL; p＜0.05), daily calorie intake (from 1440.00±257.78 kcal/day to 1503.33±191.16 kcal/day﹐p＜0.01) and dietary fiber intake (from 7.61±4.35 g/day to 22.05±2.57g/day﹐p＜0.01) after the 12-week dietary intervention. All results showed the nutritional status was improved. No significant changes were found in the levels of fasting glucose, glycohemoglobin, insulin and HOMA-IR while the calorie intake increased and the nutritional status improved.

並列關鍵字

dietary fiber ； diabetes mellitus ； glycohemoglobin ； C-reactive protein ； tube feeding formula ； HOMA-IR index

參考文獻

徐嘉吟、方信智(2006) 心血管疾病的新指標-高敏感性C-反應蛋白(hs-CRP)。基層醫學第二十一卷第三期

衛生福利部 2005-2008年的國民營養健康狀況變遷調查

鄭弘美、溫敏杰、周慧玲、李婉瑜、蔡晨瑩：利用健保申報資料探討糖尿病住院醫療照護。內科學誌 2005；16：121-8

American Diabetes Association. (2013) Standards of medical care in diabetes. Diabetes Care﹐36 Suppl 1﹐S11-66.

American Diabetes Association. (2009) Standards of medical care in diabetes.Diabetes Care﹐32 Suppl 1﹐S13-61.

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含高膳食纖維的管灌配方對糖尿病患營養狀況之影響

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