糖尿病患者对食物血糖生成指数知识的接受性及膳食调整

摘要

BACKGROUND: Glycemic index (GI) is a physiological index of carbohydrate food. It has been found out in epidemiological studies that GI is useful in controlling and preventing some chronic diseases such as diabetes,cardiovascular disease,obesity.OBJECTIVE:To investigate the acceptance and practical significance of GI knowledge in diabetic patients by comparing with the traditional education with food exchange list (FEL)as the main material.DESIGN:A comparative observational test.SETTING:Institute of Nutrition and Food Safety,Chinese Center for Disease Control and Prevention.PARTICIPANTS: Seventy-two diabetic patients volunteered to join in the study were selected from the Department Endocrinology of Beijiog No.6 Hospital from October 2000 to February 2002,including 36 males and 36 female of 10-70 years old with an average age of 58 years.METHODS:The 72 diabetic patients were randomly assigned to two groups:① GI group which received GI-based nutrition education;② FEL group receiving FEL-based nutrition education.They were educated for 5 months by means of classes,personal education and consultation by telephone.The changes of knowledge,food selection and blood glucose in the diabetic patients were observed before and after education.MAIN OUTCOME MEASURES:Changes of the awareness of nutrition education,fasting blood glucose (FBG) and 2-hour postprandial blood glucose (2hPBG) before and after education.RESULTS: All the 72 diabetic patients were involved in the analysis of results.①The correct answering rates after education were obviously higher than that before education (P<0.01).Before education,the correct rates of answers to GI questions in the Gl group were lower than the correct rates of answers to FEL questions in the FEL group (0 vs.6.5%,P<0.01).After education,the correct rates in the Gl group were higher than those in the FEL group (92.2%VS.79.4%,P<0.01): whereas there were no significant differences in the average correct rate of answer to the same question between the two groups (P>0.05).The Gl group was better than the FEL group in selecting cereal,fruit,bean and its.products (P<0.01).② The FBG and 2hPBG after education were lower than those before education in both groups(P<0.01),whereas there was no significant difference between the two groups (P>0.05).CONCLUSION:The knowledge of GI was better accepted than that of FEL by the diabetic patients in dietary treatment.%背景:血糖生成指数是含碳水化合物食物的生理学特征性指数,食物血糖生成指数在糖尿病、心血管病和肥胖等慢性病的预防控制中具有重要的应用价值和实际意义.目的:了解与传统的食物交换表为主要宣传材料的教育方法相比较,糖尿病患者对食物血糖生成指数知识的接受性和实际意义.设计:对比观察实验.单位:中国疾病预防控制中心营养与食品安全所.对象:选择2000-10/2002-02在北京市第六医院内分泌科就诊的糖尿病患者72例,年龄18～70岁,平均58岁,男女各半.方法:将72例糖尿病患者随机分为2组:①血糖生成指数组:以不同食物的血糖生成指数为主要教育材料.②食物交换表组:以传统的食物交换表为主要教育材料.采用课堂讲座、个别辅导、电话咨询等方式教育5个月.观察教育前后糖尿病患者对所授知识的知晓率、食物选择和血糖变化等.主要观察指标:教育前后营养教育知识知晓率、空腹血糖及餐后2 h血糖变化.结果:纳入糖尿病患者72例,均进入结果分析.①患者教育后对各个问题的正确回答率明显高于教育前(P《0.01).教育前,血糖生成指数组对血糖生成指数问题正确回答率低于食物交换表组对食物交换表问题的正确回答率(0,6.5%,P《0.01);教育后,血糖生成指数组对血糖生成指数问题正确回答率高于食物交换表组对食物交换表问题的正确回答率(92.2%,79.4%.P《0.01).而对相同问题的平均正确回答率,两组间差异不明显(P》0.05).在谷类食物的种类及制作方法、水果类、豆类及其制品的选择上,血糖生成指数组均优于食物交换表组(P《0.01).②两组教育后空腹血糖和餐后2 h血糖均低于教育前(P《 0.01),但组间比较,差异不明显(P》0.05).结论:在糖尿病营养教育中,患者对血糖生成指数知识的接受性优于食物交换表知识.