| Objective:In recent years,low-carbohydrate diet has become an important treatment for diabetic and obese patients,and its effective control of obesity and improvement of blood sugar levels have become the focus of more and more people.However,there are still differences in the acceptance of low-carbohydrate diets.In this study,patients with type 2 diabetes combined with overweight/obesity in a tertiary hospital in Hefei were used to intervene in the diet,and the general condition and dietary nutrition status of patients were understood through diabetes diet questionnaire and 24-hour diet review table.Flash Glucose Monitoring(FGM)is used to monitor blood glucose,blood glucose fluctuations and hypoglycemia during continuous glucose wearing;Fasting blood glucose(FPG),2-h plasma glucose(2h PG)and glycated hemoglobin(Hb A1C)were obtained from clinical blood samples before and after the intervention.1.Compare the total energy intake and standard,content and proportion of various nutrients,blood sugar,blood lipids,hypoglycemia and adverse reactions in patients with type 2 diabetes mellitus and overweight/obesity in the Low carbohydrate diet(LCD)group before and after intervention.2.Compare the total energy intake,content and proportion of various nutrients,blood sugar,blood lipids,hypoglycemia and adverse reactions of patients with type 2 diabetes mellitus and overweight/obese patients.3.Compare the total energy intake,various nutrient content and proportion,blood sugar,blood lipid,hypoglycemia and adverse reactions of the LCD group and the ND group at baseline.4.After intervention,the total energy intake,content and proportion of various nutrients,blood sugar,blood lipids,hypoglycemia and adverse reactions of the LCD group and the ND group were compared.Methods: From June 2022 to February 2023,we selected 60 patients with type 2diabetes mellitus complicated with overweight/obesity in a tertiary hospital in Hefei,Anhui Province,and adopted non-contemporaneous experimental research methods.According to the convenience sampling method,patients admitted from June 2022 to September 2022 were the control group,and patients admitted from September 2022 to December 2022 were the experimental group.The low-carbohydrate diet(LCD)intervention was used in the experimental group and the low-fat diet(ND)intervention was used in the control group.The duration of the intervention was 2 phases during hospital stay and three months after discharge.During hospitalization,generally for 2weeks,signed informed consent form,wearing FGM,and after 2 weeks of intervention,by reading FGM values,we analyzed the effect of the diet of both groups on blood glucose volatility in patients with type 2 diabetes and overweight/obesity,and observed the occurrence of hypoglycemia levels.After three months,we compared macronutrients,fasting blood glucose(FPG),2-h plasma glucose,and glycosylated hemoglobin(Hb A1C)before and after LCD and ND interventions to explore the effects of the two dietary patterns on blood glucose levels.After three months,we compared triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-c),and high-density lipoprotein cholesterol(HDL-c)before and after LCD and ND interventions to explore the effect of the two diets on blood lipid levels and to observe the occurrence of hypoglycemia and adverse effects.Outcome:1.Changes in macronutrients: there were no significant differences in total calories,macronutrient energy and mass intake between the two groups before the intervention(P>0.05).After the intervention,the carbohydrate energy and mass of the LCD group were significantly lower than before the intervention(P<0.001),and the average carbohydrate accounted for 38% of the total energy.Fat energy and mass were significantly increased in the ND group(P<0.001),lipids accounted for 25% of total energy,and there was little significant difference in protein energy and mass between the two groups after the intervention(P> 0.05)。2.There were no significant differences in waist circumference,hip circumference and BMI between the two groups before intervention(P>0.05).Changes in waist circumference,hip circumference and BMI: After three months of intervention,the waist circumference,hip circumference and BMI of the LCD group and the ND group decreased compared with the previous group,and there were statistical differences(P<0.05).Both the LCD group and the ND group could reduce waist circumference,hip circumference,and BMI,and the LCD reduction was greater than the ND reduction.3.There were no significant differences in FPG,2h PG and Hb A1 c between the two groups before intervention(P>0.05).Blood glucose changes: after three months of intervention,FPG,2h PG and Hb A1 c in the LCD group and ND group were lower than the baseline,and the FPG,2h PG and Hb A1 c in the LCD group were lower than those in the ND group,and the differences were statistically significant(P<0.05).4.There were no significant differences in TG,TC,HDL and LDL between the two groups before intervention(P>0.05).Blood lipid changes: there were no significant differences between TG,TC,HDL and LDL before intervention between the LCD group and the ND group(P<0.05).After intervention,LCD improved plasma TG and HDL-c levels in a statistically significant manner(P<0.05).5.Blood glucose standard time and blood glucose fluctuation changes: during hospitalization,analysis of FGM spectrum treatment,the daily glucose level of the LCD group was significantly lower than that of the ND group,and the TIR level also increased,and the volatility was smaller than that of the ND group.6.There was no significant difference in the number of occurrences of hypoglycemia in the ND group before the intervention.There was no significant difference in the number of episodes of hypoglycemia between the two groups(P>0.05).Conclusions: Conclusion: Low-carbohydrate diet can reduce waist circumference,hip circumference,body weight,BMI,FPG,2h PG,Hb A1 c,TG,improve blood glucose,increase HDL-c level,reduce blood glucose volatility,and reduce the number of occurrences of hypoglycemia in patients with type 2 diabetes mellitus and overweight/obese patients in the short term.It is worthy of clinical application. |
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