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研究生:陳加津
研究生(外文):Chia-Chin Chen
論文名稱:第二型糖尿病患者發病年齡與日常飲食的關係
論文名稱(外文):The Relationship between Dietary Intake and Age Onset of Disease in Type 2 Diabetes Mellitus
指導教授:莊秀美莊秀美引用關係
口試委員:林季千傅茂祖
口試日期:2015-07-30
學位類別:碩士
校院名稱:國立中興大學
系所名稱:生命科學院碩士在職專班
學門:生命科學學門
學類:生物學類
論文種類:學術論文
論文出版年:2015
畢業學年度:103
語文別:中文
論文頁數:36
中文關鍵詞:第2型糖尿病飲食型態發病年齡糖化血色素生活型態
外文關鍵詞:T2DMDietary IntakeAge OnsetA1CLife Style
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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.

中文摘要 i
ABSTRACT iii
目錄 v
表目錄 vii
圖目錄 viii
第一章、 前言 1
第二章、 文獻探討 3
一、 糖尿病流行病學 3
二、 糖尿病的簡介 3
(一) 糖尿病分類 3
(二) 糖尿病病理學 4
(三) 糖尿病診斷標準 6
(四) 糖尿病併發症的預防與治療 7
(五) 醫療營養治療 10
三、 糖尿病患共同照護模式簡介 12
第三章、 研究設計與方法 14
(一) 研究對象及收案時間 14
(二) 統計分析 14
第四章、 研究結果 15
(一) 受試者基本人口學及生活、飲食習慣、生化資料之分析 15
(二) 受試者基本人口學及生活、飲食習慣、生化資料之差異 16
(三) 不同年齡之新發病第2型糖尿病人之十組主要營養素攝取量分析 17
(四) 不同年齡之已發病第2型糖尿病人之十組主要營養素攝取量分析 18
(五) 不同年齡層之新發病第2型糖尿病人在主要營養素攝取量之分析 18
(六) 不同年齡層之新發病第2型糖尿病人在主要營養素攝取量之差異性 19
(七) 不同年齡層之已發病第2型糖尿病病人在主要營養素攝取量之分析 19
(八) 不同年齡層之已發病第2型糖尿病病人在主要營養素攝取量之差異性 20
第五章、 討論 21
第六章、 結論 22
第七章、 參考文獻 24

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