| Objective:To explore the efficacy evaluation and guiding significance of low-carbohydrate diet(LCD)guidance in traditional endocrinology clinics combined with nutrition counseling clinics in patients with type 2 diabetes mellitus(T2DM)whose blood sugar control is not up to standard.Methods:A total of 120 T2 DM patients with substandard blood glucose control who were hospitalized in the Department of Endocrinology and Thyroid Medicine,West Coast Hospital,Qingdao University Affiliated Hospital from December 2019 to December 2020 were selected and randomly divided into an observation group(n=62)and a control group(n=58).On the basis of endocrine outpatient treatment,the observation group went to the nutrition counseling outpatient clinic at the same time,while the control group went to the routine endocrine outpatient clinic.The enrolled patients had a fixed amount of exercise and were guided by clinicians.The dietitian gave the patients LCD diet guidance according to their diet habit,physical activity intensity,BMI level,blood sugar and blood fat level.The intervention period was 6 months,and the main observation indicators were:waist-to-hip ratio(WHR),body weight(BW),body mass index(BMI),glycated hemoglobin(Hb A1c),fasting blood glucose(FBG),and 2-hour postprandial blood glucose(2h PBG).Islet beta cell function index(HOMA-β),insulin resistance index(HOMA-IR),blood lipid profile(TG,TC,HDL,LDL),25-hydroxyvitamin D(25(OH)D),uric acid,carbohydrate antigens 19-9(CA19-9),carcinoembryonic antigen(CEA),carbohydrate antigen 724(CA724).Results:(1)After LCD intervention,body weight,waist circumference,Hb A1 C,FBG,2h PBG,TG,TC,HOMA-β,MES,UA,CEA,CA19-9,CA724 in observation group were significantly lower than those before intervention(t=2.585～7.328,P<0.05);high-density lipoprotein(HDL)and serum 25(OH)D levels were significantly higher than those before intervention(t=-2.892,-3.380,P<0.05);(2)the levels of Hb A1 C,FBG,2h PBG,MES,TG,CEA and CA724 in the control group were significantly lower than those before treatment(t = 2.503 ～ 6.517,p <0.05),and the levels of serum 25(OH)D were significantly higher than those before treatment(t =-2.971,p < 0.05);There was no significant difference in body weight,waist circumference,TC,HDL,LDL,HOMA-IR,HOMA-β and uric acid(t = 1.075 ～ 1.470,P > 0.05);(3)The weight,waist circumference,FBG,2h PBG,HOMA-IR,MES,TG,CA19-9 of the observation group decreased more than that of the control group(t =-3.055～-2.049,p < 0.05).The difference of TG,HDL,LDL,CEA,CA724,HOMA-β,uric acid and serum 25(OH)D between the two groups before and after treatment was not significant(P > 0.05),but the improvement range of the observation group was obviously better than that of the control group;(4)Taking Hb A1c<6.5% and FBG<7mmol/L as blood glucose compliance,there was a significant difference in the compliance rates between the two groups(X~2=5.372,4.163,P<0.05).Taking Hb A1c<7% and 2h PBG<10mmol/L as the blood glucose standard,there was no significant difference in the standard reaching rate between the two groups(X~2=2.639,3.071,P>0.05);(5)Taking TG<1.7mmol/L and TC<4.5mmol/L as blood lipid compliance,there were significant differences in the compliance rates between the two groups(X~2=3.442,4.359,P<0.05).Taking LDL<2.6mmol/L as the blood lipid compliance,there was no significant difference in the compliance rate between the two groups(X~2=1.034,P>0.05);Conclusion:On the basis of traditional endocrine outpatient treatment,combined with nutrition clinic to give LCD dietary guidance,it can reduce body weight,improve abdominal obesity in T2 DM patients,reduce the levels of Hb A1 C,FBG,TC,HOMA-IR,CA19-9,improve insulin resistance,and increase Hb A1 C,FBG,TG,TC compliance rate,thereby delaying the development of macrovascular complications and microvascular complications in patients with T2 DM,reducing the economic burden of patients with T2 DM,and improving the quality of life of patients. |
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