Application Of Glycemic Load Food Exchange Based On IMB Model In Dietary Intervention Of Obese Patients With Type 2 Diabetes Mellitus

Objective:To investigate the effect of glycemic load food exchange method based on IMB model on blood glucose control in obese patients with type 2 diabetes,so as to provi-de reference for the future dietary intervention model in obese patients with type 2 diabetes.Method:A total of 70 obese patients with type 2 diabetes who visited the department of endocrinology from March 2019 to November 2019 were selected as the study object by convenience sampling method.According to the parity of the last two digits of the patient’s outpatient number,the patients were divided into the control group with an odd number and the experimental group with an even number.A total of 35 patients in the control group were given the dietary intervention of traditional food exchange portion.A total of 35 patients in the experimental group were treated with IMB model based glycemic load food exchange method.The changes of blood glucose,blood lipid,anthropometric index and self-management behavior scores in the two groups were observed after 3 months of intervention.Results:1.Blood glucose correlation index comparisonThere was no difference in FPG,2hPG and HbA1 c between the two groups before the intervention(P>0.05),and the experimental group was lower than the control groupafter the intervention,with statistically significant difference(P<0.05).Before and after intervention,FPG,2hPG and HbA1 c were all lower in the two groups(P<0.05).2.Blood lipid-related index comparisonThere was no difference in the TC,TG,LDL and HDL values between the two groups before the intervention(P>0.05).After intervention,TC,TG and LDL in the experimental group were all lower than those in the control group,with statistically significant differences(P<0.05).After intervention,HDL of the test group was higher than that of the control group,but there was no difference(P>0.05).Before and after intervention,the TC,TG and LDL values of the two groups were all reduced,with statistically significant differences(P<0.05).After the intervention,HDL value was higher than before the intervention,and the difference was statistically significant(P<0.05).3.Comparison of anthropometric indicatorsThere was no difference in body weight,BMI and waist circumference between the two groups before the intervention(P>0.05),and the experimental group was lower than the control group after the intervention(P<0.05).Before and after the intervention,the body weight,BMI and waist circumference of the two groups were all reduced,with statistically significant differences(P<0.05).4.Self-management behavior score comparisonIntervention in two groups of patients before self management behavior score and the dimension scores than had no difference(P > 0.05),and after the intervention,the experimental group except as medical medicine dimension self-management behavior score and each dimension scores are higher than the control group,the difference was statistically significant(P < 0.05),two groups of patients according to medical medicine dimension scores were increased,but no difference(P > 0.05).Before and after the intervention,the total score of self-management behavior and scores of each dimension were increased in both groups,with statistically significant difference(P<0.05).5.Comparison of total energy intake throughout the day and glycemic load throughout the dayThere was no difference between the total energy intake of the two groups and the total glycemic load of the two groups before the intervention(P>0.05).After the intervention,the experimental group was lower than the control group,and the difference was statistically significant(P<0.05).Before and after the intervention,the total energy intake and the whole day glycemic load of the two groups were both reduced,and the difference was statistically significant(P<0.05).Conclusion:The application of glycemic load food exchange serving based on IMB model reduce the blood glucose,blood lipid and anthropometric indicators,improve the self-management behavior of patients and improve their self-management ability,can help control the total energy intake and GL value,make the diet of obese patients with type 2diabetes more reasonable.It can improve the effect of dietary intervention in obese patients with type 2 diabetes,which is of great significance for controlling blood glucose and delaying the development of the disease.