关键词: 糖尿病, 2型；膳食, 低碳水化合物；新城镇居民；糖脂代谢；自我效能；饮食依从性

Abstract: Background　Diet management is a basic treatment for diabetics，an increasing population in China.Although low-carb diet is beneficial to improving diabetics' glycolipid metabolism，their long-term adherence to this diet is poor，since strict carbohydrate control is significantly different from the traditional diet.Objective　To investigate the effect of low-carb breakfast in the treatment of type 2 diabetes mellitus （T2DM） in new town residents.Methods　By use of convenience sampling，90 new town residents with T2DM were sampled from Dongping Health Center of Lishui District，Nanjing from August 2018 to March 2019 and were equally divided into the experimental group and control group by flipping a coin.Both groups had lunch and supper without restriction of carbohydrates，but the control group had breakfast with health education based on the 2016 Chinese Dietary Guideline（hereafter referred to as the Guideline），while the experimental group had low-carb breakfast.Food volume was estimated with a standard bowl recommended by the Guidelines and a map for quantifying dietary intake.Fasting plasma glucose （FPG），glycosylated hemoglobin （HbA1c），total cholesterol （TC），triglyceride，high-density lipoprotein cholesterol （HDL-C），low-density lipoprotein cholesterol （LDL-C），blood glucose 2 hours after eating breakfast，and the score of Self-Efficacy for Diabetes（SED） were measured at baseline，3 and 6 months after intervention，respectively.Diet adherence was estimated at 2 weeks，3 and 6 months after intervention，respectively.Results　Except 5 dropouts （5.6%），including 2 in the control group due to cerebral infarction recurrence or troubles with diet control，and 3 in the experimental group due to relocation，working outside，or refusal of follow-up，other cases were included for final analysis.After 3 months of intervention，the blood glucose two hours after eating breakfast of the experimental group was lower than that of the control group （P<0.05）.Compared to baseline，the blood glucose two hours after eating breakfast and HbA1c in the control group decreased significantly after 3 and 6 months of intervention （P<0.05）；the blood glucose two hours after eating breakfast，HbA1c，HDL-C，LDL-C，and triglyceride in the experimental group showed significant decrease after 3 months of intervention（P<0.05），and after 6 months of intervention，these 5 indicators still demonstrated a significant decrease，furthermore，FPG also obtained a notable decrease （P<0.05）.After 6 months of intervention，the SED score of the experimental group was higher than that of the control group （P<0.05）.The SED scores increased significantly in both groups after 3 and 6 months of intervention （P<0.05）.Six-month intervention benefited the SED score of the experimental group more significantly than 3-month intervention （P<0.05）.The diet adherence of the two groups showed a successive increase at 2 weeks，3 and 6 months after intervention （P<0.05）.Conclusion　Both two types of breakfast could effectively improve the glycolipid metabolism，self-efficacy and dietary adherence of this group，but low-carb breakfast is more superior in terms of improving glycolipid metabolism and self-efficacy.

Key words: Diabetes mellitus, type 2；Diet, carbohydrate-restricted；New town residents；Glucose and lipid metabolism；Self-efficacy；Diet compliance