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

摘要： 背景　我国糖尿病患病率逐年升高，饮食管理是糖尿病治疗的基础措施。低碳水化合物饮食虽对糖尿病患者的糖脂代谢有益，但严格的碳水化合物控制与我国传统饮食文化差距较大，导致患者长期饮食依从性欠佳。目的　探讨低碳水化合物早餐治疗新城镇2型糖尿病（T2DM）患者的效果。方法　采用便利抽样法选取2018年8月—2019年3月就诊于南京市溧水区东屏镇卫生院的90例新城镇T2DM患者为研究对象，采用抛硬币法将其分为试验组和对照组，每组45例。以标准碗和基于此而制定的食物定量图谱为研究工具，为对照组进行指南推荐早餐教育，试验组进行低碳水化合物早餐教育，两组午餐、晚餐的碳水化合物摄入比例不做限定。于干预前和干预3、6个月检测两组患者空腹血糖（FPG）、早餐后2 h血糖、糖化血红蛋白（HbA1c）、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、自我效能量表（SED）评分，干预2周和干预3、6个月记录饮食依从性。结果　对照组2例患者分别因脑梗死复发、嫌控制饮食麻烦退出研究，试验组3例患者分别因搬迁、外出打工、拒绝随访退出研究；失访率为5.6%。干预3个月试验组患者早餐后2 h血糖低于对照组（P<0.05）。对照组患者干预3、6个月早餐后2 h血糖、HbA1c低于组内干预前（P<0.05）；试验组干预3个月早餐后2 h血糖、HbA1c、HDL-C、LDL-C、TG低于组内干预前，干预6个月FPG、早餐后2 h血糖、HbA1c、HDL-C、LDL-C、TG低于组内干预前（P<0.05）。干预6个月试验组患者SED评分高于对照组（P<0.05）。两组患者干预3、6个月SED评分均高于组内干预前（P<0.05）；试验组患者干预6个月SED评分高于组内干预3个月（P<0.05）。两组患者干预3、6个月饮食依从性均高于组内干预2周（P<0.05）。结论　指南推荐早餐教育和低碳水化合物早餐教育均能有效改善新城镇T2DM患者的糖脂代谢、自我效能和饮食依从性，且低碳水化合物早餐在改善糖脂代谢、自我效能方面优于指南推荐早餐教育。

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