Energy Supply And Nutritional Intervention Study In Hospitalized Patients With Type 2 Diabetes

Objective1. To evaluate the rationality of general coefficient method to supply energy for hospitalized patients with type 2 diabetes, according to energy balance.2. To study the effect of nutrition intervention on substance metabolism of hospitalized patients with type 2 diabetes, on the level of substrate oxidation, as references for clinical nutrition therapy.Methods1. Study on energy supply in hospitalized patients with type 2 diabetesAll 100(50 men and 50 women) type 2 diabetes patients hospitalized in the Endocrinology between May 2010 and March 2011 were chosen,which were diagnosed according to diabetes diagnostic criteria of WHO in 1999. All the patients were divided into three groups according to BMI, which were normal body weight group (18.5 kg/m2≤BMI< 24 kg/m2, Group A), overweight group (24 kg/m2≤BMI< 28 kg/m2, Group B) and obesity group (BMI≥28 kg/m, Group C). In the duration of hospital stay, energy supply for patients was calculated by general coefficient method, from 20 to 30 kcal/kg ideal body weight, and the proportion of protein, fat and carbohydrate were from 15% to 20%,20% to 30% and 55% to 60%, respectively. REE were measured as soon as patients hospitalized by indirect calorimetry. And to study the differences between energy supply and REE in hospitalized patients with type 2 diabetes.2. Nutrition intervention study in hospitalized patients with type 2 diabetesNine type 2 diabetes patients hospitalized in the Endocrinology from September 2010 to March 2011 were chosen as test group. Nine type 2 diabetes outpatients in the same time were chosen as control group. In the test group, the energy supply was calculated by general coefficient method, from 20 to 30 kcal/kg ideal body weight. The proportion of protein, fat, and carbohydrate was 15% to 20%,20% to 30% and 55% to 60%, respectively. The test group was given nutrition intervention for 10 to 14 days, and the control group was given diet instruction, merely. The changes of fasting blood glucose,2-hours postprandial glucose, resting energy expenditure, respiratory quotient, non-protein respiratory quotient, substrate oxidization of protein, fat and carbohydrate of the two groups before and after intervention were compared.Results1. Study on energy supply in hospitalized patients with type 2 diabetes(1) Basic data Among the 100 type 2 diabetes,81 cases were overweight or fat. The differences of age, gender and height in three groups had no statistically significance.(2) Blood glucose index Fasting blood glucose,2-hours postprandial glucose were decreased after therapy in all three groups(P all was 0.000).(3) Nutrition therapy The differences of energy supply in three groups had no statistically significance.(4) Metabolic rate measurement index The differences of REE in the three type 2 diabetes groups had statistically significance(P=0.002).(5) Comparison of actual energy supply and REE In the normal weight type 2 diabetes, the actual energy supply is equal to REE; Overweight patients is less than REE (P=0.000) about 150 kcal; Obesity is less than (P=0.000) REE about 300 kcal.2. Nutrition intervention study in hospitalized patients with type 2 diabetes(1) Basic data Comparing the age, sex, body height, weight and BMI between the two groups, the differences had no statistically significance.(2) Blood glucose Fasting blood glucose,2-hours postprandial glucose were decreased after intervention in both two groups(P all was 0.000).(3) Metabolic rate measurement index REE had no statistically significance before and after intervention. In the test group, RQ and npRQ both had statistically significance before and after intervention (P=0.034,P=0.020),but not in control group.Conclusion(1) The general coefficient method for energy supply of type 2 diabetes is appropriate for weight maintenance.(2) Nutrition intervention can raise carbohydrate's oxidization rate and respiratory quotient, which is helpful in correcting patients'metabolic disorder.