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A Simple Meal Plan of 'Eating Vegetables before Carbohydrate' was More Effective for Achieving Glycemic Control than an Exchange-based Meal Plan in Japanese Patients with Type 2 Diabetes

‘吃醣類食物前先吃蔬菜'的飲食方式對日本糖尿病患者比飲食份量代換更有效控制血糖

摘要


本研究目的是探討“吃醣類食物之前先吃蔬菜”的飲食方式,是否比傳統的飲食份量代換更有利於糖尿病患者的長期血糖控制。為了測試這個假說,採用隨機對照試驗,比較第二型糖尿病患者的HbA1c變化情形。將101名患者根據性別、年齡、BMI、罹患糖尿病時間長短和HbA1c作分層,再隨機分配到“吃醣類食物之前先吃蔬菜”組(簡稱VBC,共69人)和傳統的飲食份量代換(簡稱EXB,共32人)。追蹤這兩組接下來24個月的血糖控制情形。在這24個月中,兩組的HbA1c都獲得明顯的改善(VBC:8.3降至6.8%,對照EXB: 8.2降至7.3%)。而在第6、9、12和24個月時,VBC組的HbA1c都顯著比EXB組低。兩組患者在飲食習慣上有相似的改善,包括減少醣類、脂肪和甜食的攝取;但VBC組的綠色蔬菜攝取量顯著增加,而水果攝取量則顯著減少。研究結果顯示,對於日本的第二型糖尿病患者而言,在24個月內,簡單的飲食計畫“吃醣類食物之前先吃蔬菜”比傳統的飲食份量代換更能有效控制血糖。

並列摘要


This study aimed to determine whether educating diabetic patients to 'eat vegetables before carbohydrate' was as effective on long-term glycemic control as a traditional exchange-based meal plan. To test this hypothesis, we carried out a randomized, controlled trial in patients with type 2 diabetes that compared changes in HbA1c as the primary outcome. A total of 101 patients were stratified according to sex, age, BMI, duration of diabetes, and HbA1c, and then randomized to receive instructions to eat either vegetables before carbohydrate (VBC, n=69) or an exchange-based meal plan (EXB, n=32). The impact of the two plans on glycemic control was compared over 24 months of follow-up. Significant improvements in HbA1c over 24 months were observed in both groups (VBC, 8.3 to 6.8% vs EXB, 8.2 to 7.3%). HbA1c levels were significantly lower in the VBC group than in the EXB group after 6, 9, 12 and 24 months of the study. Both groups exhibited similar improvements in dietary practices with respect to intake of carbohydrate, fats and sweets, while the VBC group had a significant increase in consumption of green vegetables and a significant decrease in fruit consumption. A simple meal plan of 'eating vegetables before carbohydrate' achieved better glycemic control than an exchange-based meal plan in Japanese patients with type 2 diabetes over a 24-month period.

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