第49届欧洲糖尿病研究协会年会(EASD2013)于9月23-27日在西班牙巴塞罗那召开。当地时间9月27日上午，在“Nutrition and weight loss ”壁报专场上，以色列耶路撒冷希伯来大学Hadas Rabinovitz博士及其同事共同完成的一项研究表明，与能量低的早餐相比，富含蛋白质和脂肪的早餐更有助于2型糖尿病患者控制饥饿感和血糖水平。
既往研究证实，规律吃早餐的人比不规律吃早餐的人体重指数(BMI)低，而且会给空腹血糖水平与餐后胰岛素敏感性带来好处。本研究旨在分析早餐规格和成分对2型糖尿病患者血糖控制的影响，及其与激素之间的相关性。
本研究为随机、对照、开放性试验，纳入超重/肥胖及非胰岛素依赖性的2型糖尿病患者。受试者被随机分为能量低且均衡的大份早餐组(BB)或小份早餐组(SB)(摄入量分别为日总能量的33%和12.5%)。大份早餐组饮食包含高比例的蛋白和脂肪。每两周进行一次人体测量。分别记录基线和随访13周后的空腹炎症因子，激素和脂质水平。
结果显示，59名受试者中有47人完成该试验。随访结束时，与小份早餐组相比，大份早餐组患者的糖化血红蛋白(HbA1c)和收缩压(SBP)水平降低更多。HbA1c的降低幅度分别为1.46%和4.62%，SBP的降低幅度分别为2.4和9.6mmHg。此外，大份早餐组患者的降糖药物使用剂量降低更多，相比之下，小份早餐组较多患者的降糖药物剂量有所增加。大份早餐组的饥饿评分更低，且空腹血糖水平改善更好。
研究者观点
共同作者、以色列沃尔芬森医学中心的Daniela Jakubowicz博士表示，该研究证实“富含蛋白和脂肪的大份早餐与传统低能量早餐相比，能够为2型糖尿病患者带来额外的益处。”
Hadas Rabinovitz博士说：“我们假定这些结果和炎症因子水平降低有关。随着研究的进展，我们发现小份早餐组的饥饿评分显着增加，而大份早餐组的饱腹感评分显着增加。另外，大份早餐组患者的进食冲动减少，而小份早餐组患者进食冲动增加。原因可能是富含蛋白的大份早餐抑制了ghrelin这种激素的分泌，导致饱腹感增强。”
Rabinovitz博士总结说：“我们需要进一步的研究来证实和阐明这种相对简单的饮食方法可以增强饱腹感的机制，从而更好的控制血糖。”
| Big breakfast rich in protein improved glycaemic control and satiety feeling in adults with type 2 diabetes mellitus（富含蛋白质和脂肪的丰盛早餐改善成人2型糖尿病患者的血糖控制和增强饱腹感） |
| Background and aims: Consuming breakfast has been inversely associated with BMI, fasting lipids and postprandial insulin sensitivity. The present study was designed to evaluate the effect of breakfast size and composition on glycemic control, and its association with hormone profile in adults with type 2 diabetes. Materials and methods: The present study is a randomized, controlled, open clinical trial, including overweight/obese, non-insulin-dependent adults with type 2 diabetes. Participants were randomized to balanced hypocaloric diabetic diets with either big breakfast (BB) or small breakfast (SB), (33% vs. 12.5% of total daily energy intake). The BB diet included higher percentage of protein and fat. Anthropometric measures were assessed every 2 weeks. Fasting adipokines, hormones, proinflammatory cytokines and lipid profile were performed at baseline and after a follow-up period (Week 13). Results: Of the 59 enrolled participants, 47 completed the study. At end of follow-up, greater HbA1c and systolic blood pressure reductions were observed in the BB than SB group (HbA1c: -4.62% vs. -1.46 %, p=0.047; SBP -9.58 vs. -2.43 mmHg; p=0.04). Additionally, DM medication doses were reduced in a greater proportion of the BB participants (31% vs. 0%; p=0.002) while in the SB, a greater proportion of participants had a dose increases (16.7% vs. 3.4%; p=0.002). Hunger scores were lower in the BB group and greater improvements in fasting glucose were observed in the BB group comparison to the SB group. Conclusion: A simple dietary manipulation of BB diet rich in protein and fat appears to have additional benefits compared to a conventional low-calorie diet in individuals with type 2 diabetes. |
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