管灌配方添加高膳食纖維對第2型糖尿病人的血糖控制無顯著影響

腦中風的病人常有吞嚥困難需要依賴管灌飲食的情形，糖尿病患是腦中風的危險族群，良好的血糖控制，有助於避免腦中風發生與疾病的恢復。膳食纖維已被證實對於血糖、血脂肪及胃腸道的功能有幫助。本研究的目的為：（1）探討第2型糖尿病合併腦中風病人，使用高纖的管灌配方是否有助於對血糖之控制；（2）探討高纖管灌配方，對胃腸道排便之影響。本研究對象是彰化基督教醫院腦神經科病房停留超過7天之病患，病人以隨機分派方式分為兩組，分別為高纖組（n=32）及低纖組（n=35）。病人進入病房第一天接受體位測量、血液生化值（白蛋白、總膽固醇、低密度膽固醇、高密度膽固醇）的分析及每天測量空腹（700）及飯後（1700）的血糖，並紀錄每天排便之情形。結果顯示低纖組第5天的飯後血糖值顯著低於第3天，高纖組1~7天的空腹及飯後血糖值之間，皆無統計上的差異，比較高纖組與低纖組第1~第7天的空腹及飯後血糖，亦無統計上的差異。高纖組第7天的排便次數，顯著高於第1天。研究結果顯示急性病房中依賴管灌經腸道營養的第2型糖尿病合併腦中風患者，使用一般均衡配方添加膳食纖維，對血糖的控制無顯著的改善，但是可以增加排便的次數。

關鍵字

第2型糖尿病合併腦中風病人；管灌飲食；膳食纖維；血糖控制；排便狀況

並列摘要

Cerebrovascular patients often have dysphagia and rely on tube feeding. Patients with diabetes are the high risk group of the cerebrovascular disease. A good control of blood sugar is helpful for preventing the risk of cerebrovasclar disease. Dietary fiber has been demonstrated to be beneficial on blood glucose control, lowering blood lipid profiles and increasing gastrointestinal function. The purposes of this study were: (1) to study the effect of tube feeding formula containing high fiber on blood glucose control in cerebrovascular type 2 diabetes patients; (2) to investigate the effect of the tube feeding formula containing high fiber on the stool passage condition. Sixty-seven patients who stayed over 7 days in the neuro ward of Changhua Christian Hospital were recruited. Patients were randomly assigned into high fiber group (n=32) or low fiber group (n=35). Serum albumin, total cholesterol, low density lipoprotein cholesterol and high density lipoprotein cholesterol were determined. Plasma blood glucose concentrations and stool passage frequency were measured. Patients in the low fiber group had a significantly lower postprandial blood glucose concentration when comparing the 3rd d and 5th d. There were no significant differences in fasting and postprandial blood glucose concentrations between high and low fiber groups throughout the study period. The frequency of stool passage at the 7th d were significantly higher than the 1st d in the high fiber group. Our results suggested that the commercial balance tube feeding formula containing dietary fiber had no effects on blood glucose control but could improved the stool passage frequency in cerebrovascular type 2 diabetes patients in the acute admission ward.

並列關鍵字

cerebrovascular diabetes patient ； tube feeding ； dietary fiber ； blood glucose control ； stool passage frequency

參考文獻

鄭惠信、史麗珠、謝瀛華、曹雅姿：國人膝高與身高相關性及臨床評估之應用，中華民國營養學會第二十五屆年會暨學術研討會，1999

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Baird TA, Parsons MW, Baraer PA, Butcher KS, Desmond PM, Tress BM, Colman PG, Jerums G, Chanbers BR, Davis SM. The influence of diabetes mellitus and hyperglycemia on stroke incidence and outcome. J Clin Neurosci 2002; 9: 618-26

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管灌配方添加高膳食纖維對第2型糖尿病人的血糖控制無顯著影響

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