Please use this identifier to cite or link to this item: http://hdl.handle.net/11455/92616
標題: 第二型糖尿病患者發病年齡與日常飲食的關係
The Relationship between Dietary Intake and Age Onset of Disease in Type 2 Diabetes Mellitus
作者: 陳加津
Chia-Chin Chen
關鍵字: 第2型糖尿病;飲食型態;發病年齡;糖化血色素;生活型態;T2DM;Dietary Intake;Age Onset;A1C;Life Style
引用: 1.Danaei G, Finucane MM, Lu Y, Singh GM, Cowan MJ, Paciorek CJ, Lin JK, Farzadfar F, Khang YH, Stevens GA, Rao M, Ali MK, Riley LM, Robinson CA, Ezzati M: National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants. Lancet 378:31-40, 2011: 2.Wild S, Roglic G, Green A, Sicree R, King H: Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 27:1047-1053, 2004 3.Shaw JE, Sicree RA, Zimmet PZ: Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res ClinPract 87:4-14, 2010 4.衛生福利部(2014)。102年國人死因統計結果。取自http://www.mohw.gov.tw/CHT/Ministry/DM2_P.aspx? f_list_no=7&fod_list_no=4558&doc_no=45347 5.中華民國糖尿病衛教學會(2014)。糖尿病衛教學會核心教材。台北市:中華民國糖尿病衛教學會。 6.Eriksson KF, Lindgarde F: Prevention of type 2 (non-insulin-dependent) diabetes mellitus by diet and physical exercise. Diabetologia 34:891-898, 2001 7.Page RC, Harnden KE, Cook JTE, Turner RC: Can life-styles of subjects with impaired glucose tolerance be changed? A feasibility study. Diabetic Medicine 9:562-566, 1992. 8.Bourn DM, Mann JI, McSkimming BJ, Waldron MA, Wishart JD: Impaired glucose tolerance and NIDDM: Does a lifestyle intervention program have an effect? Diabetes Care 17:1311-1319, 1994 9.Pan X-R, Li G-W, Hu Y-H, Wang J-X, Yang W-Y, An Z-X, Hu Z-X, Lin J, Xiao J-Z, Cao H-B, Liu P-A, Jiang X-G, Jiang Y-Y, Wang J-P, Zheng H, Zhang H, Bennett PH, Howard BV: Effects of diet and exercise in prevention NIDDM in people with impaired glucose tolerance: the Da Qing IGT and Diabetes study. Diabetes Care 20:537-544, 1997 10.Tuomilehto J, Lindstr?m J, Eriksson JG, Valle TT, H?m?l?inen H, Ilanne-Parikka P, Kein?nen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, Salminen V, Uusitupa M: Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 344:1343-1392, 2001 11.Baan CA, Ruige JB, Stolk RP, Witteman JC, Dekker JM, Heine RJ, Feskens EJ: Performance of a predictive model to identify undiagnosed diabetes in a health care setting. Diabetes Care 22:213-239, 1999 12.Stamler J, Vaccaro O, Neaton JD, Wentworth D Diabetes, other risk factor, and 12-yr cardiovasclar mortality for men screened in the multiple risk factor Intervention Trial. Diabetes Care 16:434-444,1993 13.Diagnosis and classification of diabetes mellitus. Diabetes Care 37:S81-90, 2014 14.Bi Y, Wang T, Xu M, Xu Y, Li M, Lu J, Zhu X, Ning G: Advanced research on risk factors of type 2 diabetes. Diabetes Metab Res Rev 28(Suppl 2): 32-39, 2012 15.Berends LM, Ozanne SE: Early determinants of type-2 diabetes. Best Pract Res Clin Endocrinol Metab 26:569-590, 2012 16.Wei JN, Sung FC, Li CY, Chang CH, Lin RS, Lin CC, Chiang CC, Chuang LM: Low birth weight and high birth weight infants are both at an increased risk to have type 2 diabetes among schoolchildren in Taiwan. Diabetes Care 26:343-348, 2003 17.Crane JM, White J, Murphy P, Burrage L, Hutchens D: The effect of gestational weight gain by body mass index on maternal and neonatal outcomes. J Obstet Gynaecol Can 31:28-35, 2009 18.Hussain A, Claussen B, Ramachandran A, Williams R: Prevention of type 2 diabetes: a review. Diabetes Res Clin Pract 76:317-326, 2007 19.Bessesen DH: Update on obesity. J Clin Endocrinol Metab 93:2027-2034, 2008 20.Buysschaert M, Bergman M: Definition of prediabetes. Med Clin North Am 95:289-297, 2011 21.Cowie CC, Rust KF, Ford ES, Eberhardt MS, Byrd-Holt DD, Li C, Williams DE, Gregg EW, Bainbridge KE, Saydah SH, Geiss LS: Full accounting of diabetes and pre-diabetes in the U.S. population in 1988-1994 and 2005-2006. Diabetes Care 32:287-294, 2009 22.Slentz CA, Tanner CJ, Bateman LA, Durheim MT, Huffman KM, Houmard JA, Kraus WE: Effects of exercise training intensity on pancreatic beta-cell function. Diabetes Care 32:1807-1811, 2009 23.Vuori IM: Health benefits of physical activity with special reference to interaction with diet. Public Health Nutr 4:517-528, 2001 24.Hu FB, Manson JE, Stampfer MJ, Colditz G, Liu S, Solomon CG, Willett WC: Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med 345:790-797, 2001 25.Hu FB, van Dam RM, Liu S: Diet and risk of type II diabetes: the role of types of fat and carbohydrate. Diabetologia 44:805-817, 2001 26.Anderson JW, Smith BM, Gustafson NJ: Health benefits and practical aspects of high-fiber diet. Am J Clin Nutr 59:1242S–1247S, 1994 27.Franz MJ, Bantle JP, Beebe CA, Brunzell JD, Chiasson JL, Garg A, Holzmeister LA, Hoogwerf B, Mayer-Davis E, Mooradian AD, Purnell JQ, Wheeler M: Evidence based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care 26:S51-S61, 2003 28.Wei JN, Sung FC, Lin CC, Lin RS, Chiang CC, Chuang LM: National surveillance for type 2 diabetes mellitus in Taiwanese children. JAMA 290:1345-1350, 2003 29.Ferrannini E: Insulin resistance versus insulin deficiency in non- insulindependent diabetes mellitus: problems and prospects. Endocr Rev 19:477-490, 1998 30.Bergman RN, Ader M: Free fatty acids and pathogenesis of type 2 diabetes mellitus. Trends Endocrinol Metab 11:351-356, 2000 31.The International Expert Committee. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care 32:1327-1734, 2009 32.邱淑媞、林宏達、游能俊、薛秀圭、林鈴華、林莉代、陳再晉、賴美淑(2001)。整合性慢性病共同照護模式「蘭陽糖尿病照護網」經驗簡介。台灣醫界,44(3),45-48。 33.衛生福利部國民健康署(2015)。糖尿病共同照護工作指引手冊。取自http://www.hpa.gov.tw/BHPNet/Web/HealthTopic/TopicArticle.aspx?No=200712250075&parentid=200712250014 34.The global burden of diabetes. Diabetes Atlas second edition, International Diabetes Federation. 15-71, 2003 35.The complications of diabetes. Diabetes Atlas second edition, International Diabetes Federation. 72-111, 2003 36.Harris MI, Flegal KM, Cowie CC, Eberhardt MS, Goldstein DE, Little RR, Wiedmeyer HM, Byrd-Holt DD: Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in U.S. adult. The Third National Health and Nutrition Examination Survey, 1988-1994. Diabetes Care 21:518-524, 1998 37.King H, Aubert RE, Herman WH: Global burden of diabetes, 1995-2025: Prevalence, numerical estimates, and projections. Diabetes Care 21:1414-1431, 1998 38.Cockram CS: The epidemiology of diabetes mellitus in the Asia-Pacific region. Hong Kong Med J 6:43-52, 2000 39.The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complication in insulin-dependent diabetes mellitus. N Engl J Med 329:977-986, 1993 40.UK prospective Diabetes Study Group. Intensive blood glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 352:937-853, 1998 41.UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular complications in type 2 diabetes (UKPDS 38). BMJ 317:703-713, 1998 42.The economic impact of diabetes. Diabetes Atlas second edition, International Diabetes Federation. 175-192, 2003
摘要: 
目的—為了評估飲食習慣和第2型糖尿病(T2DM)發病年齡的關係,以2001年糖尿病個案管理計畫(一個全國性標準化的醫療保健項目)來評估中台灣某醫學中心第2型糖尿病病人發病年齡。
研究設計和方法—從2003年1月至2006年12月,糖尿病個案管理計畫中,隨機篩選6928名糖尿病受試者。每位皆做個別化的營養評估及充分的飲食紀錄。將所有新發病的第2型糖尿病病人(N =1378)分成六組不同年齡:<40歲、40-49歲、50-59歲、60-69歲、70-79歲和80歲以上;而其餘以前就被診斷患有第2型糖尿病的受試者(N=5550),也依他們糖尿病發病年齡,分配到這六組。將每日總熱量攝取的主要營養素的攝取平均劃分為十組,G1:碳水化合物45%-50%,脂肪30%-35%和蛋白質15%-20%、G2a、G2b、G2c、G3a、G3b、G3c、G4a、G4b和G4c(G2:碳水化合物>50%、G3:碳水化合物≦45%、G4:碳水化合物45%-50%;a:脂肪>35%、b:脂肪≦30%、c:脂肪30%-35%)。
結果—年輕發病的第2型糖尿病病人,飲食習慣顯示超過60%的病例(G3a和G4a為一組)每日攝取高脂肪量。然而,年長的才發病的第2型糖尿病病人,超過60%的病例(G2b和G2c為一組)每日攝取高脂肪量。年輕發病(G3a和G4a為高脂肪組)和年長才發病(G2b和G2c為低脂肪組)的主要營養素攝取,在男女不同年齡均有統計學上顯著差異,不僅是在新發病的第2型糖尿病病人(P <0.001男性,p= 0.004女性),而且先前診斷的第2型糖尿病病人也是如此(P < 0.0001男性,p=0.001女性)。
結論—糖尿病個案管理計畫之飲食評估中得知,主要營養素為高脂肪含量的飲食習慣容易造成第2型糖尿病低齡化,然而發現攝取低脂肪含量飲食,以老年人為主,即使病人先前已經被診斷為第2型糖尿病。

OBJECTIVE—In order to evaluate the eating habits in newly developed type 2 diabetes mellitus (T2DM) and ensuing development of primary preventive intervention, a nationally standardized health care program – Diabetes Case Management Program, DCMP 2001 was implement in medical center, Mid-Taiwan.
RESEARCH DESIGN AND METHODS—From Jan. 2003 to Dec. 2006, 6928 diabetes beneficiaries were randomly and cumulatively recruited in DCMP 2001. The individualized nutritional assessment was achieved after adequate record of dietary history. All the newly developed T2DM (n=1378) were divided up into 6 groups with different age of onset of disease, <40 years, 40-49 years, 50-59 years, 60-69, 70-79 years and over 80 years, whereas the rest of previously diagnosed T2DM in this cohort (n=5550) were also fitted into these 6 groups by their ages of onset of diabetes. The macronutrient consumptions of total daily caloric intakes were classified under 10 Groups, G1: carbohydrate 45%-50% and fat 30%-35% and protein 15%-20%, G2a, G2b, G2c, G3a, G3b, G3c, G4a, G4b, and G4c (G2: CHO>50%, G3:CHO≦45%, G4: CHO 45%-50%; a: fat>35%, b: fat≦30%, c: fat 30%-35% ).
RESULTS—In case of younger onset of newly developed T2DM, the eating habits showed the more than 60% cases (G3a and G4a as a group) were high fat in their daily intakes. The older onset of newly developed T2DM, however, more than 60% case (G2b and G2c as a group) were low fat in their daily food. The differences of macronutrient consumptions between younger (G3a and G4a as a high fat group) and older (G2b and G2c as a low fat group) onset of diabetes at the different age ranges in both sexes were statistically significant not only in the newly developed T2DM (p<0.001 in male, p=0.004 in female) but also in the previously diagnosed T2DM (p<0.0001 in male, p=0.001 in female)
CONCLUSION—The results clearly indicated that the eating habits of macronutrient consumption with high fat contents would be prone to develop T2DM in younger age, whereas in case with low fat contents onset of disease would be found to be older in their life even though patients with previously diagnosed T2DM received the dietary assessment following DCMP 2001 in very recent years.
URI: http://hdl.handle.net/11455/92616
其他識別: U0005-1808201509083300
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