為探討糖尿病和糖尿病前期人群知曉高血糖狀況是否會引起營養素的攝入量的差異。研究者分析了來自2005–2011年國家健康與營養調查研究中的3725名非妊娠糖尿病或糖尿病前期的相關數據。研究表明，血糖篩查和之後的血糖狀況知曉可能影響糖尿病患者的飲食模式。本研究發表於最新一期《糖尿病治療》上(DiabetesCareDecember2014vol.37no.123143-3149)。

研究者分析了來自2005–2011年國家健康與營養調查研究中的3725名非妊娠糖尿病或糖尿病前期的成人(年齡大於等於20歲)的早晨空腹樣本，采用了了他們的24小時膳食回顧和其他數據。糖尿病和糖尿病前期的治療情況采用患者自報的形式，沒有確診糖尿病和糖尿病前期的患者以如下指標確認：分別為空腹血糖(FPG)≥126mg/dL或HbA1c≥6.5%且FPG在100–125mg/dL之間或HbA1c在5.7%–6.4%之間。每日的營養攝入量組分評估包括總熱量、糖分、碳水化合物、纖維素、蛋白質、脂肪和總膽固醇，按性別和和血糖狀況知曉狀況進行分級。營養攝入量的估計調整了年齡、種族、教育程度、體重指數、吸煙狀況和糖尿病家族史等因素。

與未確診糖尿病男性相比，診斷糖尿病男性消耗更少的糖(平均值86.8vs.116.8g)和碳水化合物(平均值235.0vs.262.1g)和更多的蛋白質(平均值67.4vs.56.6g)。同樣，與未確診糖尿病女性相比，診斷糖尿病女性消耗更少的糖(平均值79.1vs.95.7g)和更多的蛋白質(平均值67.4vs.56.6g)。但是糖尿病前期的意識與否與營養素的攝入量沒有顯著性差異。所有的參與者，不論性別或血糖狀態，消耗的平均纖維素攝入量小於美國糖尿病協會的建議(即，14g/1,000kcal)和飽和脂肪稍高於推薦值(>攝入總卡路裏的10%)。

原文摘要：

Does Knowing One’s Elevated GlycemicStatus Make a Difference in Macronutrient Intake?

OBJECTIVE To determine whether macronutrient intake differs by awareness of glycemic status among people with diabetes and prediabetes.

RESEARCH DESIGN AND METHODS We used 24-h dietary recall and other data from 3,725 nonpregnant adults with diabetes or prediabetes aged ≥20 years from the morning fasting sample of the 2005–2010 National Health and Nutrition Examination Survey. Diabetes and prediabetes awareness were self-reported; those unaware of diabetes and prediabetes were defined by fasting plasma glucose (FPG) ≥126 mg/dL or HbA1c ≥6.5% and FPG 100–125 mg/dL or HbA1c of 5.7%–6.4%, respectively. Components of nutrient intake on a given day assessed were total calories, sugar, carbohydrates, fiber, protein, fat, and total cholesterol, stratified by sex and glycemic status awareness. Estimates of nutrient intake were adjusted for age, race/ethnicity, education level, BMI, smoking status, and family history of diabetes.

RESULTS Men with diagnosed diabetes consumed less sugar (mean 86.8 vs. 116.8 g) and carbohydrates (mean 235.0 vs. 262.1 g) and more protein (mean 92.3 vs. 89.7 g) than men with undiagnosed diabetes. Similarly, women with diagnosed diabetes consumed less sugar (mean 79.1 vs. 95.7 g) and more protein (mean 67.4 vs. 56.6 g) than women with undiagnosed diabetes. No significant differences in macronutrient intake were found by awareness of prediabetes. All participants, regardless of sex or glycemic status, consumed on average less than the American Diabetes Association recommendations for fiber intake (i.e., 14 g/1,000 kcal) and slightly more saturated fat than recommended (>10% of total kcal).

CONCLUSIONS Screening and subsequent knowledge of glycemic status may favorably affect some dietary patterns for people with diabetes.