对2型糖尿病代谢结果的营养摄入顺序:系统性审查和元分析
Luisa M Saldarriaga-Callejas1, Piyush Ratan2, Eric Pasqualotto3
1Universidad CES, Medellín, Colombia. saldarriaga.luisa@uces.edu.co.
Acta diabetologica
|October 13, 2025
概括
吃碳水化合物最后在一顿饭显著降低血糖峰值和提高肠道激素水平的人2型糖尿病. 这种策略可能会改善代谢健康,但需要进一步研究长期益处.
科学领域:
- 代谢健康 代谢健康
- 内分泌学 在内分泌学.
- 糖尿病管理 糖尿病管理
背景情况:
- 宏观营养素测序,特别是碳水化合物最后 (CL) 的饮食模式,是管理2型糖尿病 (T2D) 的食后血糖的建议策略.
- 现有的关于CL策略有效性的证据是不确定的,需要进一步调查.
研究的目的:
- 评估碳水化合物最后 (CL) 饮食策略与碳水化合物第一或无序 (CF) 摄入相比对T2D成人代谢参数的影响.
- 为随机对照试验 (RCT) 提供最新的元分析,调查T2D管理中的营养摄入序列.
主要方法:
- 在PubMed,Embase和Cochrane Central数据库中对相关RCT进行了系统的文献搜索.
- 数据使用随机效应模型进行分析,以95%置信区间 (CI) 计算平均差异 (MD).
- 使用R版本4.4.2进行统计分析,通过Cochrane的Q测试和I2统计评估异质性.
主要成果:
- 这项元分析包括了17项与389名参与者的研究,分析了平行和交叉设计的数据.
- 在60分钟和120分钟后,CL策略显著降低了食后葡萄糖水平 (p < 0.01).
- 临床临床组的参与者表现出更高的食后葡萄糖类-1 (GLP-1) 水平 (p < 0.01),延迟胃空化 (p < 0.01),以及HbA1c的适度降低 (p = 0.04).
结论:
- 碳水化合物-最后的饮食模式在改善食后血糖和增强GLP-1分泌方面表现出有效性.
- 这种饮食策略还导致胃空气的延迟,有助于更好的血糖控制.
- 虽然在轻度T2D中对HbA1c的影响很小,但需要进一步的研究来证实长期益处和在晚期疾病阶段的适用性.
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