PREVENTION OF TYPE-2 (NON-INSULIN-DEPENDENT) DIABETES-MELLITUS BY DIET AND PHYSICAL EXERCISE - THE 6-YEAR MALMO FEASIBILITY STUDY
PREVENTION OF TYPE-2 (NON-INSULIN-DEPENDENT) DIABETES-MELLITUS BY DIET AND PHYSICAL EXERCISE - THE 6-YEAR MALMO FEASIBILITY STUDY
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DOI：
10.1007/bf00400196
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发表时间：
1991-12-01
期刊：
影响因子：
8.2
通讯作者：
LINDGARDE, F
中科院分区：
文献类型：
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作者：
ERIKSSON, KF;LINDGARDE, F
从先前报道的6，956例47-49岁马尔莫男性的5年筛查项目中，选择了41例早期2型（非胰岛素依赖型）糖尿病受试者和181例葡萄糖耐量受损受试者进行前瞻性研究，并测试长期干预的可行性，重点是生活方式的改变。 90%的受试者完成了一项为期5年的方案，包括最初6个月的（随机）试点研究，包括饮食治疗和/或增加体力活动或训练，并进行年度检查。 参与者的体重降低了2.3- 3.7%，而未干预的糖耐量受损受试者和正常对照受试者的体重增加了0.5- 1.7%（p < 0.0001）;最大摄氧量（ml.min-1.kg-1）分别增加了10- 14%和减少了5- 9%（p < 0.0001）。 > 50%的糖耐量受损受试者的糖耐量正常化，糖尿病的累积发病率为10.6%，并且超过50%的糖尿病患者在平均随访6年后缓解。 血压、血脂和高胰岛素血症降低，早期胰岛素对葡萄糖负荷的反应性保留。 葡萄糖耐量的改善与体重减轻（r = 0.19，p < 0.02）和健身增加（r = 0.22，p < 0.02）相关。 治疗是安全的，死亡率也很低（事实上比队列中的其他人低33%）。 我们的结论是，以饮食和体育锻炼的形式进行长期干预是可行的，即使在大规模的，并且可以实现实质性的代谢改善，这可能有助于预防或推迟显性糖尿病。
From a previously reported 5-year screening programme of 6,956 47-49-year-old Malmo males, a series of 41 subjects with early-stage Type 2 (non-insulin-dependent) diabetes mellitus and 181 subjects with impaired glucose tolerance were selected for prospective study and to test the feasibility aspect of long-term intervention with an emphasis on life-style changes. A 5-year protocol, including an initial 6-months (randomised) pilot study, consisting of dietary treatment and/or increase of physical activity or training with annual check-ups, was completed by 90% of subjects. Body weight was reduced by 2.3-3.7 % among participants, whereas values increased by 0.5-1.7 % in non-intervened subjects with impaired glucose tolerance and in normal control subjects (p < 0.0001); maximal oxygen uptake (ml.min-1.kg-1) was increased by 10-14 % vs decreased by 5-9 %, respectively (p < 0.0001). Glucose tolerance was normalized in > 50 % of subjects with impaired glucose tolerance, the accumulated incidence of diabetes was 10.6 %, and more than 50 % of the diabetic patients were in remission after a mean follow-up of 6 years. Blood pressure, lipids, and hyperinsulinaemia were reduced and early insulin responsiveness to glucose loading preserved. Improvement in glucose tolerance was correlated to weight reduction (r = 0.19, p < 0.02) and increased fitness (r = 0.22, p < 0.02). Treatment was safe, and mortality was low (in fact 33 % lower than in the remainder of the cohort). We conclude that long-term intervention in the form of diet and physical exercise is feasible even on a large scale, and that substantial metabolic improvement can be achieved which may contribute to prevent or postpone manifest diabetes.