Effect Of Loose Low Carbohydrate Diet On Metabolism In Patients With Type 2 Diabetes Mellitus

Part 1 Qualitative study on diabetes diet experience of patients withtype 2 diabetes mellitusObjective: To understand experience that patients with type 2 diabetes mellitus accepted and implemented diabetes diet.Methods: Using qualitative research method, during the March 2014- June 2014 in the first hospital affiliated to suzhou university endocrinology inpatient and outpatient of representative of 19 patients with type 2 diabetes mellitus, focusing on diabetes diet management for the interview, one-to-one in-depth interviews.Analysis of the data analysis by Colaizzi’s seven steps, the common problems in the form of the language, thinking and insights formed the theme of the internal connection.Results: Interviewing data were identified as 3 categories describing the patients’ experience: out of alignment in knowledge; implementation with obstacles; Psychological resistance.Conclusion: Patients with type 2 diabetes mellitus experienced difficulties in diabetes diet. It is essential to further explore an effective support program for them. Part 2 Effect of loose low carbohydrate diet on metabolism in patients with type 2 diabetes mellitusObjective: to explore Loose Low-Carbohydrate Diet(Loose Low Carbohydrate Diet, LLCD) for domestic operability and effect on metabolism in patients with T2DM(Type 2 Diabetes Mellitus).Methods: According inclusion and exclusion to screening patients with T2 DM, grouped through convenience sampling and according to the patient’s willings for LLCD group(N = 15) and LFD group(N = 16).LFD group received education and guidance about LFD by the hospital diabetes specialist nurses;LLCD group received education and guidance about LLCD by the experimenter, intervention time for 3 months.After three months two groups were compared macro nutrients,Hb A1 c, body weight, BMI, TC, TG, LDL- C, HLD- C, insulin dose, the frequency of hypoglycaemia before and after the intervention.Results:(1) Before the intervention, the three major nutrients were no significant difference of energy and quality between LLCD group and LFD group.After the intervention, carbohydrate calories and quality in LLCD group have decreased, the average carbohydrate accounted for 39% of total calories.The fat calories and quality in LLCD group have increased. There were significant differences in fat and carbohydrate calories and quality between LLCD group and LFD group(P<0.05). During interventions, proteins are not changed between two groups.(2) Hb A1 c levels in two groups have improved significantly compared with baseline, difference was statistically significant(P<0.05);At baseline and after the intervention, Hb A1 c level was no difference between the two groups. After the intervention, achieved rate in Hb A1 c were both significantly increased in two groups.(3) Compared with baseline, body weight, BMI, TG and HDL- C in LLCD group were improved significantly after the intervention,(P<0.01);LFD group improve in weight and BMI significantly(P<0.01). After the intervention, the metabolic indexes are no difference between groups.(4) After the interventions, LLCD group and LFD group had significant reduction in insulin dose compared with baseline,(P<0.01).Insulin dose no difference between groups.(5)After the interventions for 3 months,the frequency of hypoglycaemia in LLCD group has decreased significantly,compared with before trimester,(P<0.05).In LFD group,the frequency of hypoglycaemia had no significant change before and after the interventions.The frequency of hypoglycaemia before and after interventions had no英文摘要宽松式低碳水化合物饮食策略对2型糖尿病患者代谢指标的影响statistical difference between two groups,but the mean differences for 3 month interventions had the difference between groups(P<0.05).Conclusion: Operability of LLCD intervention strategies are confirmed, meeting the standard of a LCD.LLCD can improve blood glucose, blood lipid, reduce weight, at the same time reduce the dosage of insulin in patients with T2 DM for the short term.