| Objective: To observe the effects of different protein dietary intervention effect of nutritional support for patients with type 2 diabetes complicated with pulmonary tuberculosis,patients with pulmonary tuberculosis disease control between dietary protein supplement and analysis of type 2 diabetes mellitus.Methods: 258 patients with type 2diabetes mellitus complicated with pulmonary tuberculosis from January 1,2016 to December 31,2016 in the Xinjiang Uygur Autonomous Region chest hospital for treatment of patients,according to the inclusion and exclusion criteria included patients,self controlled by convenience sampling method were randomly divided into three groups respectively given different amounts of protein diet,low protein group: basic diet+1.0g/Kg/d protein protein intake;group +1.2g/Kg/d: basic dietary protein intake;high protein group: +1.5g/Kg/d based dietary protein intake.Enteral nutrition was the main way of nutrition support,and the patients were excluded from parenteral nutrition.The baseline survey,three groups were measured in patients with metabolic,biochemical,nutritional and anthropometric indicators,analysis before and after the intervention itself between groups and within groups of indexes before and after the change and correlation.Results: 1)before the intervention of dietary survey found that patients with T2DM-PTB protein,energy and dietary intake of nutrients and nutrients reference intake Chinese residents(DRIs),total 83.49%of the population has not reached the standard,including protein,trace elements such as calcium and nutrient intake was low;FFQ dietary survey results and dietary Chinese comparison of guidelines recommended intake of nutrient intake is not balanced.Three groups of Valley potato and vegetable intake;fish and shrimp,and soy products,milk and dairy products,fruit intake was low;and poultry meat,eggs,fat intake in dietary recommendations for weight range.2)the three groups before and after intervention were compared between groups before and after the intervention,body mass index(BMI)grade difference was statistically significant(=14.495,P<0.05);found in the human body measurement index,there was statistical significance only TSF and W/HR(F=3.284,P=0.039;F=3.685,P=0.026),found in serum detection index,fasting blood glucose(FBG),two hour postprandial blood glucose(2hPBG),glycosylated hemoglobin(HbA1c)were decreased,the differences were statistically significant(P<0.05);hemoglobin(Hb),serum total protein(TP),serum albumin(ALB),serum albumin(PA),serum iron(SI)increased,the differences were statistically significant(P<0.05);CRP,TG,HDL and LDL decreased,the differences were statistically significant(P<0.05),observed the body index C-emergency response protein(CRP)decreased,the difference was statistically significant(P < 0.05);and total lymphocyte count(TLC),erythrocyte sedimentation rate(ESR),creatinine(Cr)and urea nitrogen(BUN)did not change significantly,had no statistical significance(P>0.05);3)the difference between the three groups before and after intervention when compared anthropometric indices of systolic blood pressure(SDP),TSF and W/HR were statistically significant(P < 0.05);biochemical index in FBG,2hPBG,HbA1 c were significantly different(P<0.01),Hb,TP,ALB,PA,SI increased,there were significant differences(P<0.01)TG,HDL,CRP,and LDL decreased,there was statistically significant(P<0.05),TC,TLC,ESR,Cr and BUN did not change obviously no significant difference(P > 0.05);4)Comparison between groups,low protein group and the protein group and high protein group and the protein group effect Is not obvious,only part of the data is statistically significant,but low protein group and high protein group index in addition to Cr and BUN,other indexes had significant difference(P <0.05);5)The low protein group,medium protein group and high protein group before and after intervention group(before and after in itself)the comparison,low protein index change is not obvious,the protein in the groups have changed,high protein groups changed obviously;6)intervention in the three groups of TB smear had significant difference(2? =38.652,P=0.01),the number of TB sputum smear high protein group decreased more significantly.Conclusion: 1)the nutritional status of patients with T2DM-PTB is currently facing a double risk of "nutritional deficiency" and "excess nutrition".Dietary structure is not reasonable,nutrient intake is not balanced,not up to 83.49%of the standard,should strengthen the patient’s individual diet and guidance.2)in the premise of stability of total calories,high protein diet intervention can improve the nutritional status of patients with T2DM-PTB,TP,ALB increase,maintain or increasethe non fat tissue,reduce body fat,improve glucose metabolism and lipid metabolism,increase insulin sensitivity,benefit the patients.3)and the degree of protein intake is positively related to the nutritional status of patients with change,high protein 1.5g/Kg/d support dose group in improving the biochemical and immune indexes of patients,improve immunity and reduce complications than medium protein group and low protein group have better effect.4)no adverse effects on renal function and lipid metabolism were observed in the high protein diet intervention trial.It is recommended that T2DM-PTB patients take the maximum safe dose of 1.5g/Kg/d protein,and the protein is the best.Therefore,T2DM-PTB can increase the protein intake for patients to improve the nutritional status,enhance the body resistance,to promote the rehabilitation of the body,help maintain normal metabolism and nutritional needs,maintain long-term blood glucose levels and muscle content have beneficial effect. |
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