The Effects of a Mediterranean Diet on the Need for Diabetes Drugs and Remission of Newly Diagnosed Type 2 Diabetes: Follow-up of a Randomized Trial
The Effects of a Mediterranean Diet on the Need for Diabetes Drugs and Remission of Newly Diagnosed Type 2 Diabetes: Follow-up of a Randomized Trial
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DOI：
10.2337/dc13-2899
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发表时间：
2014-07-01
期刊：
影响因子：
16.2
通讯作者：
Giugliano, Dario
中科院分区：
文献类型：
--
作者：
Esposito, Katherine;Maiorino, Maria Ida;Giugliano, Dario
目的 评估饮食干预对血糖控制、糖尿病药物需求和 2 型糖尿病缓解的长期影响。 研究设计和方法 最初，在一项双臂试验设计中，超重、新诊断 2 型糖尿病的中年男性和女性被随机分配到低碳水化合物地中海饮食 (LCMD；n = 108) 或低脂饮食 (n = 107)。 4年后，对仍未服用糖尿病药物的参与者进行进一步随访，直至达到主要终点（需要糖尿病药物）；还评估了糖尿病（部分或完全）缓解以及体重、血糖控制和心血管危险因素的变化。 结果 经过低脂组 6.1 年和 LCMD 组 8.1 年的总随访后，所有参与者均达到了主要终点；中位生存时间分别为 2.8 年 (95% CI 2.4-3.2) 和 4.8 年 (4.3-5.2)。整体随访的未调整风险比为 0.68 (0.50-0.89；P < 0.001)。 LCMD 参与者更有可能经历任何缓解（部分或完全），低脂饮食组的第一年患病率为 14.7% (13.0-16.5%)，第 6 年为 5.0% (4.4-5.6%)，而第 1 年为 4.1% (3.1-5.0%)，第 6 年为 0%。 结论 在新诊断的 2 型糖尿病患者中，与低脂饮食相比，LCMD 可更大程度地降低 HbA(1c) 水平、提高糖尿病缓解率并延迟对糖尿病药物的需求。
OBJECTIVETo assess the long-term effects of dietary interventions on glycemic control, need for diabetes medications, and remission of type 2 diabetes.RESEARCH DESIGN AND METHODSOriginally, in a two-arm trial design, overweight, middle-aged men and women with newly diagnosed type 2 diabetes were randomized to a low-carbohydrate Mediterranean diet (LCMD; n = 108) or a low-fat diet (n = 107). After 4 years, participants who were still free of diabetes medications were further followed up until the primary end point (need of a diabetic drug); remission of diabetes (partial or complete) and changes in weight, glycemic control, and cardiovascular risk factors were also evaluated.RESULTSThe primary end point was reached in all participants after a total follow-up of 6.1 years in the low-fat group and 8.1 years in the LCMD group; median survival time was 2.8 years (95% CI 2.4-3.2) and 4.8 years (4.3-5.2), respectively. The unadjusted hazard ratio for the overall follow-up was 0.68 (0.50-0.89; P < 0.001). LCMD participants were more likely to experience any remission (partial or complete), with a prevalence of 14.7% (13.0-16.5%) during the first year and 5.0% (4.4-5.6%) during year 6 compared with 4.1% (3.1-5.0%) at year 1 and 0% at year 6 in the low-fat diet group.CONCLUSIONSIn patients with newly diagnosed type 2 diabetes, an LCMD resulted in a greater reduction of HbA(1c) levels, higher rate of diabetes remission, and delayed need for diabetes medication compared with a low-fat diet.