臺灣博碩士論文加值系統

國人糖尿病盛行率逐年增加，且罹患人口年齡層也有年輕化的趨勢，飲食在糖尿病治療中與藥物、運動同樣重要。過去研究指出攝取膳食纖維具有延緩餐後血糖、改善血脂肪和降低C-反應蛋白的好處。
本研究主要目的在探討對於台灣長期照顧機構中，使用管灌飲食且空腹血糖値異常的住民，使用含高膳食纖維的管灌營養品，對於血糖控制及營養狀況的影響。
本研究最後完成連續介入12週的受試者一共有30位，其中男性13名，女性17名，研究期間收集受試者第0週與第12週的血液進行生化檢驗。結果顯示，在介入12週後，受試者的前白蛋白由21.74±6.53 mg/dL顯著增加至25.52±6.72 mg/dL(p＜0.01)，TIBC由270.23±72.66 ug/dL顯著增加至305.07±75.29 ug/dL(p＜0.05)，每日熱量攝取由1440.00±257.78 kcal/day顯著增加至1503.33±191.16 kcal/day(p＜0.01)，膳食纖維攝取由7.60±4.35 g/day顯著增加至22.05±2.57g/day(p＜0.01)，表示在介入含高膳食纖維的管灌配方12週後，受試者的營養狀況有獲得改善。另外，在受試者熱量攝取增加且營養狀況改善下空腹血糖、糖化血色素、胰島素及HOMA-IR並無顯著變化。

The prevalence of diabetes is increasing every year and there is a growing trend of people suffering from diabetes at a younger age in Taiwan. Along with medication and exercise, diet is critically important in the management of diabetes. Numerous studies have shown that dietary fiber provides benefits including delaying postprandial blood glucose elevation and decreasing serum lipid and C-reactive protein (CRP).
The aim of this study was to investigate the effect of tube feeding formula containing high dietary fiber on blood sugar control and nutritional status in tube-fed nursing home residents with impaired fasting glucose.
A total number of 30 participants (13 male and 17 female) have completed a 12-week dietary intervention and underwent blood biochemical tests at baseline and 12 weeks. Results showed significant increases in prealbumin levels (from 21.74±6.53 mg/dL to 25.52±6.72 mg/dL; p＜0.01), total iron-binding capacity (TIBC) (from 270.23±72.66 ug/dL to 305.07±75.29 ug/dL; p＜0.05), daily calorie intake (from 1440.00±257.78 kcal/day to 1503.33±191.16 kcal/day﹐p＜0.01) and dietary fiber intake (from 7.61±4.35 g/day to 22.05±2.57g/day﹐p＜0.01) after the 12-week dietary intervention. All results showed the nutritional status was improved. No significant changes were found in the levels of fasting glucose, glycohemoglobin, insulin and HOMA-IR while the calorie intake increased and the nutritional status improved.

目錄
頁次
表次……………………………………………………………………Ⅰ
圖次……………………………………………………………………Ⅱ
附錄……………………………………………………………………Ⅲ
中文摘要………………………………………………………………Ⅳ
英文摘要………………………………………………………………Ⅴ
壹、前言………………………………………………………………1
貳、文獻整理…………………………………………………………4
一、糖尿病概述………………………………………………………4
(一)糖尿病成因……………………………………………………4
(二)糖尿病的分類…………………………………………………4
(三)糖尿病的併發症………………………………………………5
二、糖尿病的照護指標………………………………………………6
三、膳食纖維的定義及代謝…………………………………………8
四、膳食纖維與糖尿病………………………………………………12
參、研究目的…………………………………………………………17
肆、材料與方法………………………………………………………18
一、研究設計…………………………………………………………18
二、研究對象…………………………………………………………18
三、研究方法…………………………………………………………19
(一)體位測量………………………………………………………19
(二)熱量需求………………………………………………………21
(三)生化檢驗………………………………………………………21
(四)臨床評估………………………………………………………24
(五)飲食評估………………………………………………………24
(六)試驗配方………………………………………………………24
(七)統計分析………………………………………………………26
伍、結果與討論………………………………………………………27
一、受試者基本資料…………………………………………………27
二、管灌餵食含高膳食纖維配方對受試者血糖之影響……………27
三、管灌餵食含高膳食纖維配方對受試者體位之影響……………33
四、管灌餵食含高膳食纖維配方對受試者血液蛋白質及其代謝產物和CRP濃度之影響………………………………………………………33
五、管灌餵食添加膳食纖維配方對受試者血脂及肝功能之影響…36
六、管灌餵食添加膳食纖維配方對受試者血液電解質及礦物質之影響
之影響…………………………………………………………………38
陸、結論………………………………………………………………40
柒、研究限制…………………………………………………………41
捌、參考文獻…………………………………………………………42
玖、附錄………………………………………………………………49

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