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营养策略,以纠正 postbariatric 低血糖患者的低血糖值:一个随机控制的三臂交叉试验
Katja A Schönenberger1,2, Antonio Ferreira1, Céline Stebler1
1Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism (UDEM), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Diabetes, obesity & metabolism
|June 19, 2023
概括
在Roux-en-Y胃绕道术 (RYGB) 后,用15g的葡萄糖纠正后性低血糖,效果不如较低剂量或蛋白质棒. 较低的葡萄糖剂量和蛋白质可以更好地稳定血糖,避免反弹低血糖症.
科学领域:
- 内分泌学 在内分泌学.
- 代谢障碍 代谢障碍 代谢障碍
- 腹部外科手术的结果
背景情况:
- 腹腔后低血糖症 (PBH) 是Roux-en-Y胃绕道术 (RYGB) 后的一种并发症.
- 营养干预措施用于管理PBH,但它们的有效性需要进一步评估.
研究的目的:
- 为了比较不同营养策略的有效性,以纠正后RYGB患者的低血糖症.
- 评估葡萄糖和蛋白质干预对PBH血糖控制的影响.
主要方法:
- 一个随机的,受控的,三臂交叉试验,涉及八名成年人与PBH后RYGB.
- 低血糖症是由混合餐引起的,并用15g的葡萄糖 (G15),5g的葡萄糖 (G5) 或蛋白质棒 (P10) 来纠正.
- 主要结局:在调整后40分钟内,在目标血葡萄糖范围 (3.9-5.5 mmol/L) 中度过的时间.
主要成果:
- 干预之间在目标葡萄糖范围内的时间没有显著差异.
- 与G5和P10相比,15g的葡萄糖 (G15) 导致超过5.5mmol/L的时间更长,葡萄糖/胰岛素峰值更高.
- 在38%的病例中,G15导致反弹低血糖症,与G5和P10不同.
- 与G15和G5.5相比,蛋白条 (P10) 显示了更高的补丁后葡萄糖水平.
结论:
- 应重新考虑在RYGB后对PBH进行15g葡萄糖的再养.
- 较低的葡萄糖剂量 (例如5g) 似乎足以提高葡萄糖水平,并且可能更安全.
- 含有蛋白质的零食可以在管理PBH时提供葡萄糖稳定性益处.
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