含麩醯胺酸及膳食纖維之管灌配方對糖尿病患者營養狀況之改善

The improvement on the nutritional status of diabetic patients by tube feeding formula containing glutamine and dietary fiber

蔡嘉勳

麩醯胺酸 ； 膳食纖維 ； 糖尿病 ； 管灌配方 ； glutamine ； inulin ； diabetes ； tube feeding formula

中山醫學大學營養學研究所學位論文

2017年

碩士

王進崑

繁體中文

糖尿病的治療指引中明確指出：「糖尿病是一種慢性病，一旦患病即無法根治，僅能在飲食、運動、藥物三者的配合下力求控制」。對於長期照護機構住民而言，飲食的攝取與種類選擇其影響更顯重要。 本研究擬使用含麩醯胺酸及膳食纖維營養配方作為居家照護糖尿病患者的單一營養來源，測試完全使用糖尿病營養配方是否能改善營養狀況，觀察血糖變化、血壓及血脂之情況控制。本研究由居家安養中心臥床病人中篩選出31位糖尿病且以完全管灌營養補充的患者。依個案之體位、活動量及疾病種類，評估計算受試者之每日熱量需要，給予每日熱量1661.29±137.66大卡，研究介入時間為12周，探討介入前後營養改善狀況。 結果顯示，各受試者經過糖尿病營養配方補充後，受試者熱量攝取及蛋白質顯著上升且達營養需求目標值(p<0.05)；血漿白蛋白及總蛋白皆有上升(p<0.05)；病患血糖變化平穩且控制良好，其中糖化血色素及HOMA-IR皆有顯著下降(p<0.05)；血脂方面，低密度脂蛋白膽固醇有下降，三酸甘油酯有上升情形，但仍維持在標準範圍內。另外，在肝及腎臟功能方面，營養品補充後沒有顯著的變化，皆在標準參考範圍內。 本研究顯示，以含麩醯胺酸及膳食纖維之營養配方作為單一營養來源，可以改善病患之營養狀況並達較穩定的血糖控制成效。

Diabetes treatment guidelines clearly states "Diabetes is a chronic disease, once the disease is incurable, can be controled in diet, exercise and medication. For long-term care residents, the dietary intake could be well impacted." In this study, nutritional formula containing glutamine and inulin was used for long-term care residents with diabetes as a single source of nutrition. This study enrolled 31 diabetic subjects with a long-term care and required tube feeding supplements. Average daily calorie intake for each subject was 1661.29 ± 137.66 kcal, and total intervention time peiod was 12 weeks. After intervention, the calorie and protein intake were greatly increased (p <0.05). Serum total protein and albumin were increased (p <0.05). Blood glucose was well controlled, glycated hemoglobin and HOMA-IR were significantly decreased (p <0.05). Serum LDL-cholesterol was decreased, triglycerides level was increased but still within the normal range. The liver and kidney functions were in normal condition. This study showed that the intervention of nutritional formula containing glutamine and inulin could improve the nutritional status and maintain well regulation of blood glucose for the enrolled diabetic subjects.

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