| Diabetes mellitus（DM）is one of the most common chronic non-communicable diseases in the world.It is a health problem that attracts public attention.Among them,type 2 diabetes accounts for more than 90%[1].Type 2 diabetes mellitus（T2DM）,like obesity,will have a great impact on diabetes patients and the national health care system all over the world[2].The epidemic situation of diabetes mellitus in China is particularly severe.In recent years,the prevalence of diabetes mellitus has been rising,and the number of diabetes mellitus patients ranks first in the world[3].At present,comprehensive management is advocated for the prevention and treatment of diabetes mellitus and its complications.The lifestyle management of diet combined with exercise is an important part of comprehensive treatment of diabetes mellitus,and is also the basis of treatment of diabetes mellitus.For new diabetic patients,lifestyle intervention of diet combined with exercise can be carried out first.If blood sugar and glycosylation are not up to the standard,glycosylated hemoglobin is still more than 7%,it needs to be treated with hypoglycemic drugs.The traditional management of diabetic lifestyle is difficult to adhere to for patients with poor self-discipline,so the compliance is poor and the effect is unsatisfactory.In recent years,food substitution has gradually appeared in the public’s attention.Studies at home and abroad have shown that food substitution combined with aerobic exercise can improve insulin resistance,and make patients’glycolipid metabolic indicators effectively improved.In this study,a lifestyle management scheme combining alternative diet with aerobic exercise,personalized meal list and one-to-one guidance was applied to type 2 diabetes mellitus patients,and its intervention effect was observed.Objective:To explore the intervention effect of diet-led lifestyle management on type 2diabetes mellitus and its complications,and to explore a simple and effective intervention method for the prevention and treatment of type 2 diabetes mellitus.Methods:Clinical intervention trial was used in this study.170 patients with type 2 diabetes were selected from the outpatient or inpatient department of the Affiliated Hospital of Yan’an University from March to August 2017.Patients with type 2 diabetes were divided into intervention group（104 cases）and control group（66 cases）for 42 days.The intervention group was given substitute kit supplemented with personalized meal list,aerobic exercise and one-to-one health guidance.The control group was given traditional diabetic diet and aerobic exercise and took hypoglycemic drugs under the guidance of professional endocrinologist according to the patient’s condition.The weight,body fat rate,body mass index（BMI）,visceral fat rate（visceral fat rate）,waist circumference,fasting blood glucose（FPG）,glycosylated hemoglobin（HbA1c）,fasting insulin（FINS）,insulin resistance index（HOMA-IR）,triglyceride（TG）and total cholesterol（TC）were compared before and 16 days after intervention.Changes of high density lipoprotein cholesterol（HDL-C）,low density lipoprotein cholesterol（LDL-C）,aspartate aminotransferase（AST）,alanine aminotransferase（ALT）,urea nitrogen（BUN）,serum creatinine（SCr）,uric acid（UA）,plasma homocysteine（Hcy）.Paired t test,independent sample t test,rank sum test and2 test were performed with SPSS 22.0 software.Results:During the intervention period,82 patients in the intervention group reduced the dosage of hypoglycemic drugs to varying degrees,and even stopped taking drugs.The rate of drug withdrawal and reduction reached 78.5%（82/104）,while the control group had no drug withdrawal and reduction.Before intervention,there were no significant differences in body weight,waist circumference,BMI,visfats,body fat rate,TG,TC,HDL-C,LDL-C,FPG,FINS,HbA1c,HOMA-IR and levels between the two groups（P>0.05）;after intervention,body weight,BMI,waist circumference,body fat rate and visfats rate of the intervention group were all lower than those before intervention,while those of the control group decreased only BMI and body fat rate,with statistical differences.Significance of learning（P<0.05）.After intervention,the levels of FPG,FINS,HOMA-IR,HbA1c,TG,TC and LDL-C in intervention group were lower than those before intervention（P<0.05）,and there was no significant difference between HDL-C and before intervention（P>0.05）.After intervention,only TC level in the control group was lower than that before intervention,with significant difference（P<0.05）;FPG,FINS,HOMA-IR,HbA1c,TG,TC and LDL-C levels had no significant difference（P>0.05）.The differences of body weight,BMI,waist circumference,body fat rate,visfats rate,TG,TC,LDL-C,FPG,FINS,HbA1c,HOMA-IR before and after intervention in the intervention group were significantly different from those in the control group（P<0.05）.In addition,after 42 days of intervention,the levels of ALT and Hcy in the intervention group were lower than those at baseline（P<0.05）,while the levels of AST,BUN,SCr and UA had no significant difference compared with those at baseline（P>0.05）.There was no significant difference in ALT,AST,BUN,SCr,UA and Hcy levels before and after intervention in the control group（P>0.05）.Conclusion:1.The lifestyle management led by diet and beverage can reduce the body weight,BMI,waist circumference,body fat rate and lactone rate of overweight type 2 diabetes mellitus in a short time.2.The lifestyle management led by diet and beverage can effectively improve glycolipid metabolic indicators such as FPG,Hb A1C,FINS,HOMA-IR,TG,TC,HDL-C and LDL-C in patients with overweight type 2 diabetes mellitus.3.The lifestyle management led by diet and beverage can reduce the use of hypoglycemic drugs to varying degrees in the intervention process of some overweight type 2 diabetes mellitus,or even stop taking drugs.4.The lifestyle management led by diet and beverage has better dependence and safety,and can provide a scientific and simple nutritional intervention for overweight type 2 diabetes patients with short course of disease and poor self-discipline. |
