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教你“一手”搞定糖尿病饮食!

2016-08-15 Joy 医学界内分泌频道

导语:糖尿病的治疗首先是“管住腿、迈开腿”,其次才是进一步的药物治疗。想做到正确的糖尿病饮食及生活方式,其实有很多小技巧,小编教你一手搞定!糖尿病的治疗首先就是“管住腿、迈开腿”,其次才是进一步的药物治疗,所以患者的自我管理具有极其重大的意义。但是就目前的临床工作情况来看,我们还有很大的提升空间——许多患者对于正确糖尿病的饮食及生活方式认识不够。8 月 7 日,在中华医学会糖尿病学分会 2016

导语:糖尿病的治疗首先是“管住腿、迈开腿”,其次才是进一步的药物治疗。想做到正确的糖尿病饮食及生活方式,其实有很多小技巧,小编教你一手搞定!


糖尿病的治疗首先就是“管住腿、迈开腿”,其次才是进一步的药物治疗,所以患者的自我管理具有极其重大的意义。但是就目前的临床工作情况来看,我们还有很大的提升空间——许多患者对于正确糖尿病的饮食及生活方式认识不够。


8 月 7 日,在中华医学会糖尿病学分会 2016 年教育管理研讨会的糖尿病营养教育专场,来自江苏省省级机关医院的莫永珍主任护师为各位同道带来了“糖尿病营养教育工具面面观”的精彩演讲。


让我们一起学习糖尿病患者自我管理的经验和方法:


一、手掌法则:吃多少手说了算!



“手掌法则”——糖尿病食物大小选择方式


1、拳头量——碳水化合物(淀粉和水果):


可以选用相当于自己两个拳头大小的淀粉类食物,如馒头、花卷、米饭等,就可以满足一天碳水化合物的需求量了。水果一天需要量则相当于1个拳头大小。


2、掌心量——蛋白质:


50克的蛋白质相当于掌心大小、约为小指厚的一块。每天吃50-100克的蛋白质即可满足一天需求。


3、两手抓量——蔬菜:


两只手能够抓住的菜量(1把)可相当于500克的量,每天进食500至1000克蔬菜可满足需要。当然这些蔬菜都是低碳水化合物蔬菜如绿豆、豆芽、卷心菜等。


4、拇指尖量——脂肪:


要限制脂肪(黄油)的摄入,每天仅取拇指的尖端(第一节)就足够。


5、两指并拢量——瘦肉量:


切一块与食指厚度相同,与两指(食指和中指并拢)的长度、宽度相同的瘦肉相当于50克的量,可满足一天需要。


总结5句话:


(1)尽量要多吃:满捧两手的蔬菜;


(2) 适当要吃一些:食指和拇指的轮廓大小的水果;


(3) 一定要吃的:半个手掌大小的鱼、鸡蛋、肉、豆腐;


(4) 零食从三者中选择其一:甜点(月饼等):单手食指和拇指的轮廓大小;②糕饼(蛋糕等):单手手掌中心大小;③零食(虾条薯片等):单手一小把;


(5) 其他必须的:米饭:每餐1浅碗~1碗半;薯类:如土豆、中号1个左右;牛奶:250ml;


二、健康餐盘法


2011年6月2日,美国农业部公布了一份耗时两年设计的健康饮食新指南,用餐盘式的图标取代了沿袭20年的美国食品金字塔指南,提醒民众改变不良饮食习惯。




2016年5月13日,国家卫计委发布《中国居民膳食指南(2016)》,并推出了中国居民平衡膳食餐盘(2016),通过可视化的图形,指导大众在日常生活中进行具体实践。



三、碳水化合物计份法


碳水化合物计数法,是一种计算一日正餐和点心中的碳水化合物克数,或食物份数大小的方法。碳水化合物来源有:大米、面条、面包、麦片和谷物;马铃薯、玉米、豌豆和蚕豆;水果和果汁;牛奶和酸奶;甜点和食糖。


我们知道,碳水化合物是身体中重要的能量来源,但也是造成肥胖的原因之一。碳水化合物的合理摄入对于糖尿病患者的良好管理具有重要意义,若患者需注射胰岛素,那么胰岛素剂量需要与饮食中的碳水化合物相匹配。


所以监测碳水化合物,无论是通过碳水化合物计份法、交换份法,或者是根据经验估计,都是达到血糖控制的重要策略。


四、“吃动两平衡”换算工具


“吃动两平衡”工具是糖尿病患者进行饮食和运动换算的自我管理实用工具,由一个小圆盘和一个中间盘组成。



吃动平衡小圆盘


吃动平衡中间盘


中间盘上列出39种常见食物,通过转动小圆盘就能查到食物(固定重量)的能量以及消耗这些能量各项运动所需的锻炼时间。



吃动两平衡换算表


通过吃动两平衡换算表可了解要消耗不同分量的不同食物的热量、各类运动需要的时间长短。例如,200克的熟米饭的热量为232千卡,消耗它需要健身走58分钟,或打羽毛球46分钟,或慢跑58分钟。


专家寄语:


从“手掌法”、“三分餐盘”、“碳水化合物计数法”到学组开发的“吃动平衡工具”、“手持餐盘教具”的面世,我们的营养教育已经从“教育E”向“支持S”的方向发展,目的就是为了达到以下目标:


1、实现并保持代谢指标尽可能接近正常安全值(血糖、血压及血脂);


2、通过改变营养素的摄入和生活方式,以防止或减缓慢性并发症的发生率;


3、满足个人的营养需求;


4、仅限制食物的选择,以保持患者对饮食的乐趣。


做到这些,就能够既让病人可以掌握科学的知识,同时又能够真的指导和适用于日常的饮食管理,这样才能促进患者行为的改变,并能够长久地融入生活。

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    2017-01-01 jiangxianchen

    看第三遍的飘过

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=167220, encodeId=6abe16e22073, content=看第三遍的飘过, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuHfSLw3PzIKiaSnTBUuAtRkrrxWpibukl35iciaGtBq4LYQv4ian1tPC3IdmzWI2dZ3cDC8wUg5CnBxlJ/0, createdBy=33a51675735, createdName=jiangxianchen, createdTime=Sun Jan 01 11:20:16 CST 2017, time=2017-01-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=109901, encodeId=09181099011b, content=实用,收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/23/ac01daf0962458a9eb8c0b1e2f6ce5bc.jpg, createdBy=04b81710322, createdName=1771ae4158m, createdTime=Fri Sep 02 22:24:00 CST 2016, time=2016-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106763, encodeId=9d97106e633e, content=收藏并转发了,要提醒一下,是每天,不是每餐!, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160616/IMG5762A3665DC7B3997.jpg, createdBy=df0a1649089, createdName=ys2323, createdTime=Mon Aug 29 10:33:00 CST 2016, time=2016-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=105768, encodeId=7984105e68a7, content=图要是能保存就更好了, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuHfSLw3PzIKiaSnTBUuAtRkrrxWpibukl35iciaGtBq4LYQv4ian1tPC3IdmzWI2dZ3cDC8wUg5CnBxlJ/0, createdBy=33a51675735, createdName=jiangxianchen, createdTime=Sat Aug 27 21:03:00 CST 2016, time=2016-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=103753, encodeId=6e33103e5362, content=好好学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Aug 25 18:36:00 CST 2016, time=2016-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=103344, encodeId=952410334494, content=呃,看不清楚小图吖。, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d56e1941937, createdName=兴趣者1025, createdTime=Wed Aug 24 23:17:00 CST 2016, time=2016-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=99967, encodeId=b2a19996e03, content=好好学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Wed Aug 17 19:51:00 CST 2016, time=2016-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=99306, encodeId=1fe49930601, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Tue Aug 16 16:01:00 CST 2016, time=2016-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=99307, encodeId=4f6b9930eb6, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Tue Aug 16 16:01:00 CST 2016, time=2016-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=99064, encodeId=03ed9906432, content=很好用, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3081918192, createdName=19820323, createdTime=Tue Aug 16 08:43:00 CST 2016, time=2016-08-16, status=1, ipAttribution=)]
    2016-09-02 1771ae4158m

    实用,收藏

    0

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    2016-08-29 ys2323

    收藏并转发了,要提醒一下,是每天,不是每餐!

    0

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    2016-08-27 jiangxianchen

    图要是能保存就更好了

    0

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    2016-08-25 忠诚向上

    好好学习一下

    0

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    2016-08-24 兴趣者1025

    呃,看不清楚小图吖。

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=167220, encodeId=6abe16e22073, content=看第三遍的飘过, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuHfSLw3PzIKiaSnTBUuAtRkrrxWpibukl35iciaGtBq4LYQv4ian1tPC3IdmzWI2dZ3cDC8wUg5CnBxlJ/0, createdBy=33a51675735, createdName=jiangxianchen, createdTime=Sun Jan 01 11:20:16 CST 2017, time=2017-01-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=109901, encodeId=09181099011b, content=实用,收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/23/ac01daf0962458a9eb8c0b1e2f6ce5bc.jpg, createdBy=04b81710322, createdName=1771ae4158m, createdTime=Fri Sep 02 22:24:00 CST 2016, time=2016-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106763, encodeId=9d97106e633e, content=收藏并转发了,要提醒一下,是每天,不是每餐!, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160616/IMG5762A3665DC7B3997.jpg, createdBy=df0a1649089, createdName=ys2323, createdTime=Mon Aug 29 10:33:00 CST 2016, time=2016-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=105768, encodeId=7984105e68a7, content=图要是能保存就更好了, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuHfSLw3PzIKiaSnTBUuAtRkrrxWpibukl35iciaGtBq4LYQv4ian1tPC3IdmzWI2dZ3cDC8wUg5CnBxlJ/0, createdBy=33a51675735, createdName=jiangxianchen, createdTime=Sat Aug 27 21:03:00 CST 2016, time=2016-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=103753, encodeId=6e33103e5362, content=好好学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Aug 25 18:36:00 CST 2016, time=2016-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=103344, encodeId=952410334494, content=呃,看不清楚小图吖。, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d56e1941937, createdName=兴趣者1025, createdTime=Wed Aug 24 23:17:00 CST 2016, time=2016-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=99967, encodeId=b2a19996e03, content=好好学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Wed Aug 17 19:51:00 CST 2016, time=2016-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=99306, encodeId=1fe49930601, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Tue Aug 16 16:01:00 CST 2016, time=2016-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=99307, encodeId=4f6b9930eb6, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Tue Aug 16 16:01:00 CST 2016, time=2016-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=99064, encodeId=03ed9906432, content=很好用, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3081918192, createdName=19820323, createdTime=Tue Aug 16 08:43:00 CST 2016, time=2016-08-16, status=1, ipAttribution=)]
    2016-08-17 忠诚向上

    好好学习一下

    0

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    2016-08-16 doctorJiangchao

    继续学习

    0

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    2016-08-16 doctorJiangchao

    继续关注

    0

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    2016-08-16 19820323

    很好用

    0

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糖尿病肾病是导致美国及世界上慢性和终末期肾脏疾病的首要原因。人口统计学和治疗的变化可能会影响糖尿病肾病的患病率和临床表现。本研究旨在分析美国成人糖尿病患者的肾病的临床表现。 采用横断面研究探究1988年至2014年间参与国家健康和营养检查调查的20岁或以上的糖尿病患者。糖尿病定义为糖化血红蛋白大于6.5%或使用降血糖药物。 主要研究结果,白蛋白尿(尿白蛋白/肌酐比值≥30毫克/克),大

PLoS Med:骑自行车远离糖尿病

背景:无论是休闲娱乐还是上班出行,自行车都是很好的选择。本研究的目的是:探究娱乐和通勤自行车、骑车习惯的改变和2型糖尿病(T2D)风险的关系。方法:从基线的1993到1997年,纳入了来自丹麦的24623名男性和27890名女性,年龄50-65岁,没有T2D和其他慢性疾病,进行一系列的评估,包括生活方式问卷调查和自行车习惯。大约5年后,进行第二次评估,参与者完成了一份新的、最新的生活方式问卷。结果

Obesity:代谢正常型肥胖也会增加糖尿病的发病风险,与非酒精性脂肪肝无关

近日,发表在Obesity的一项研究指出:代谢正常型肥胖也会增加糖尿病的发病风险,与非酒精性脂肪肝的存在与否无关,梅斯医学小编整理研究主要内容如下: 目的 本研究旨在通过大型队列研究来验证是否代谢正常型肥胖会增加糖尿病的发病危险,而无论其是否伴有非酒精性脂肪性肝病(NAFLD)。 方法 研究纳入74509 名基线时期代谢正常的成年人,代谢正常定义为,除外腰围较大外,无任

Diabetes Care:糖尿病到底增加心血管疾病和患癌死亡风险多少?

大量西班牙研究人员调查后发现,由于糖尿病会增加民众出现心血管疾病、癌症和其他疾病的风险,由此会使民众过早死亡的风险显著增加。 研究人员通过对超过55000名民众调查分析后发现,糖尿病患者患肝癌、结直肠癌、肺癌、肝肾疾病、心血管疾病如心梗和卒中等风险增加,因此糖尿病患者过早死亡的风险增加。这项研究结果发表在Diabetes Care。 既往研究表明,尽管近年来糖尿病患者总体死亡率降低,但糖尿病患者的

盘点:开给糖尿病患者的运动处方

糖尿病的患病率、病死率很高,除药物和饮食治疗外,运动治疗也是糖尿病整体治疗不可或缺的一环。科学合理的运动可以增强体质,提高心肺功能及机体免疫力。对糖尿病患者而言,运动还可以减轻体重、改善胰岛素抵抗、辅助降低血糖(尤其是餐后血糖)、减少降糖药物用。下面梅斯医学小编为大家整理了几种对糖尿病预防和治疗有效的运动方式。【1】骑自行车远离糖尿病近期发表在PLoS Med杂志上一项研究表明,骑自行车远离糖

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