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Title :外来2型糖尿病患者における2年間の食事摂取状況の実態把握
Title alternative :Dietary intake in Japanese outpatients with type 2 diabetes: 2-year follow up study
Authors :金胎, 芳子
堀川, 千嘉
鶴田, 恵
飯塚, つかさ
山谷, 恵一
香川, 靖雄
Publisher :新潟人間生活学会
Issue Date :Mar-2018
Journal Title :人間生活学研究
Volume :9
Start Page :25
End Page :35
ISSN :1884-8591
Abstract :【目的】食事療法は2型糖尿病患者の自己管理に必須であるが、その経年的な実践状況についての検討は不足している。そこで本研究では、2型糖尿病患者における2年間の食事摂取状況の実態把握を行った。【方法】外来に通院する2型糖尿病患者60名 (平均年齢:66.8歳, 男性比率:65.0%) について、食物摂取頻度調査法を用い2014年とその2年後に把握した食品群・栄養素摂取状況を経年的に比較した。【結果】対象者の調査開始時の平均値は、罹病期間:10.2 ± 6.6 年,HbA1c:7.4 ± 1.1 %,BMI(Body Mass Index):23.6 ± 4.4 kg/m2 であった。2年後は、BMI や血糖、血中脂質に有意差はみられず、収縮期血圧のみ調査開始時より高値であった(137.3 ± 13.6 vs. 132.8 ± 14.7 mmHg, p=0.031)。食事摂取状況は、2年間でエネルギー摂取量に有意差はみられなかったが、脂質エネルギー比が増加し(25.8 ± 5.3 vs. 27.3 ± 6.2 %, p= 0.030)、食物繊維摂取量が低下した(13.8 ± 4.6 vs.12.5 ± 3.6 g, p= 0.030)。食品群別では、野菜総量は摂取量が低下し(280 ± 132 vs. 229 ± 114 g, p=0.004)、肉類摂取量が増加した(45 ± 31 vs. 57 ± 48 g, p= 0.029)。調査開始時のHbA1c 値とBMI による層別解析では、HbA1c<7%群で食物繊維と野菜類の総量摂取量が2年後に低値となり(p=0.048, 0.001)、HbA1c≧7%群で脂質摂取量が高値であるが( p= 0.042)、脂質エネルギー比でみると有意差は認められなかった。BMI 25kg/m2 未満群では、脂質エネルギー比が2年間で増加し(p= 0.043)、食物繊維と野菜類の総量摂取量が低下し(p= 0.003, 0.003)、乳類の摂取量が増加した(p= 0.022)。BMI 25kg/m2 以上群は、エネルギーや三大栄養素摂取に有意差は認められず、食品群別で、緑黄色野菜のみ2 年後の摂取量が低値となった(p= 0.008)。【結論】外来2型糖尿病患者の2年間の食事摂取状況の変化が明らかとなった。糖尿病療養状況を考慮した、各患者の食事摂取状況の経時的な把握を行う必要性が示唆された。
Objective: The dietary intake across the ages of patients with type 2 diabetes is sparse though nutritional therapy is essential for self-managing for diabetes. We aimed to clarify 2-year dietary intake among Japanese individuals with type 2 diabetes from a community hospital-based registry. Methods: This study was analyzed in 60 patients with type 2 diabetes (Men%:65.0%, Age: 66.8y, BMI: 23.6kg/m2, HbA1c:7.4%) using the food frequency questionnaire based on food groups using paired t-test and Wilcoxon signed-rank test. Results: BMI, HbA1c, and serum lipid revels did not show significant difference over 2 years. Systolic blood pressure level in 2 years was significantly high than the value of baseline (137.3±13.6 vs. 132.8±14.7mmHg, p= 0.031). There was no significant difference in mean energy intake and proportions of protein and carbohydrate comprising total energy intake over 2 years. The proportion of fat intake increased (25.8±5.3 vs. 27.3±6.2%, p=0.030) and the fiber intake decreased in the 2 years (13.8±4.6 vs. 12.5±3.6g, p=0.030). As a dietary intake by food groups, vegetable intake was decreased (280±132 vs. 229±114g, p=0.004) and meat intake increased (45±31 vs. 57±48g, p= 0.029) in the 2 years. In addition, among patients who had HbA1c <7%, the intake of fiber and vegetable intakes in 2 years decreased compared with those at baseline (p= 0.048, 0.001), and patients with HbA1c ≥7% had higher fat intake value in 2 years than that of baseline (p= 0.043), though the proportion of fat intake did not show significant difference over 2 years. According to BMI, patients without overweight (BMI< 25kg/m2)raised the proportion of fat intake and milk/milk products intakes (p= 0.043 and 0.022, respectively) and reduced fiber and vegetable intakes (p= 0.003 and 0.003, respectively) in 2 years. The patients with overweight show higher green vegetable intake in 2 years, but the intakes of other nutrients and food group did not significantly changed. Conclusion: Our study clarified the characteristics and change of dietary intake of Japanese outpatients with type 2 diabetes and considering the treatment status would be useful for understanding each dietary intake of each patients with type 2 diabetes.
Keywords :2型糖尿病
Type 2 diabetes
Medical nutritional therapy
Dietary intakelongitudinal study
longitudinal study
Type Local :Journal Article
Language :jpn
URI :http://hdl.handle.net/10623/74945
Appears in Collections:01 人間生活学研究

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