广东医学2025，Vol.46Issue(4)：598-604,7.DOI:10.13820/j.cnki.gdyx.20243209
不同饮食方式的1型糖尿病患者葡萄糖目标范围内时间的差异及相关性
Differences in time in rangeand its correlations among type 1 diabetes mellitus patients following different dietary patterns
摘要
Abstract
Objective To investigate the differences in time in range(TIR)and its associated factors among type 1 diabetes mellitus(T1DM)patients following different dietary patterns,based on continuous glucose monitoring systems(CGMS).Methods Ninety-three T1DM patients treated at our hospital from March 2022 to March 2024 were random-ly assigned into three groups:the vegetarian diet group(n=31),the low-carbohydrate diet group(n=31),and the standard diet group(n=31).Patients in the vegetarian group received subcutaneous insulin injections combined with a vegetarian diet,while the low-carbohydrate group received subcutaneous insulin injections and a low-carbohydrate diet.The standard diet group received subcutaneous insulin injections without additional dietary interventions.Clinical data,glucose control indicators[fasting blood glucose(FBG)target rate,2-hour postprandial glucose(PPG-2h)target rate for breakfast,lunch,and dinner],glucose variability indicators[TIR,mean amplitude of glucose excursions(MAGE),largest amplitude of glucose excursions(LAGE),time above range(TAR),time below range(TBR)],and lipid profiles[triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)]were compared among groups.Pearson correlation analysis was used to explore the relationship between TIR and various indicators,and simple linear regression analysis was conducted to determine whether TIR influ-ences lipid profiles.Results After 1 month of treatment,all groups demonstrated an increase in average TIR and decrea-ses in MAGE,LAGE,TAR,and TBR,with more significant changes observed in the vegetarian and low-carbohydrate diet groups compared to the standard diet group(P＜0.05).The FBG target rate and PPG-2h target rates for breakfast,lunch,and dinner were significantly higher in the vegetarian and low-carbohydrate diet groups compared to the standard diet group(P＜0.05).Post-treatment,TG,TC,and LDL-C levels decreased in all groups,with more significant re-ductions in the vegetarian and low-carbohydrate diet groups compared to the standard diet group(P＜0.05).However,there were no statistically significant differences in HDL-C levels among the groups after treatment(P＞0.05).Pearson correlation analysis showed that TIR was negatively correlated with MAGE,LAGE,TG,TC,and LDL-C in the vegetari-an and low-carbohydrate diet groups and in all patients combined(P＜0.05).Simple linear regression analysis indica-ted that TIR was an influencing factor for TG,TC,and LDL-C levels(P＜0.05).Conclusion Different dietary pat-terns combined with insulin therapy lead to differences in glucose variability,glucose control,and lipid levels among T1DM patients.Both vegetarian and low-carbohydrate diets are beneficial for improving TIR in T1DM patients.Further-more,TIR is negatively correlated with MAGE,LAGE,TG,TC,and LDL-C,suggesting that TIR is an effective indica-tor for evaluating glucose control in T1DM patients.关键词
1型糖尿病/饮食方式/动态血糖监测系统/葡萄糖目标范围内时间Key words
type 1 diabetes mellitus/dietary pattern/continuous glucose monitoring system/glucose target time in range分类
医药卫生引用本文复制引用
周培雯,周智明,濮先明,朱俊,麦镇流,谭奇江,袁妙兰..不同饮食方式的1型糖尿病患者葡萄糖目标范围内时间的差异及相关性[J].广东医学,2025,46(4):598-604,7.基金项目
中山市社会公益科技研究项目(220126214249689) （220126214249689）
