THE SAFETY AND EFFICACY OF A CONTROLLED LOW-ENERGY (VERY-LOW-CALORIE) DIET IN THE TREATMENT OF NON-INSULIN-DEPENDENT DIABETES AND OBESITY
THE SAFETY AND EFFICACY OF A CONTROLLED LOW-ENERGY (VERY-LOW-CALORIE) DIET IN THE TREATMENT OF NON-INSULIN-DEPENDENT DIABETES AND OBESITY
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DOI：
10.1001/archinte.148.4.873
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发表时间：
1988-04-01
影响因子：
--
通讯作者：
LOCKWOOD, DH
中科院分区：
文献类型：
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作者：
AMATRUDA, JM;RICHESON, JF;LOCKWOOD, DH
我们评估了高度补充的控制低能量（1764 kJ [420 kcal]）饮食治疗非胰岛素依赖型糖尿病和肥胖症的安全性和有效性。6名肥胖的糖尿病女性，体重在理想体重的143%到297%之间，在代谢病房进行了48天的研究。受试者在8天的控制期内摄入维持体重的饮食，随后40天的实验饮食含有1764千焦（420千卡）的蛋白质（43%的能量摄入）、碳水化合物（51%）和脂肪（6%）的混合物，并补充矿物质、微量元素和维生素。通过24小时心电图记录监测受试者体内氮和矿物质的平衡，以及心律失常的出现。体重下降迅速且持续，平均为10.1%。超过40天0.8%。空腹血糖水平从16.2 +-下降。1.9 mmol/L(293 .+-。36毫克/分升)至6.9。0.8 mmol/L(126 .+-。16 mg/dL)。同样，血红蛋白A1c水平从0.11 +-下降。0.009（11.2%）。0.9%)到0.8。0.001（8.2%）。1.1%)。尿c肽水平从62.2 +-下降。15.6 nmol/48 h至20.0。5.9 nmol/48 h，第39至40天，血糖值下降，主要发生在前7天。血清胆固醇和甘油三酯浓度下降。氮、钾和镁的平衡为负，分别为-1.7 g/24 h、-2.2 mEq/24 h和-2.9 mg/dL。血压降低，无需直立。静息代谢率平均下降18%，但仍在正常范围内。三碘甲状腺原氨酸水平也有所下降。24小时动态心电图读数显示，没有任何患者出现明显的慢性心律失常或快性心律失常。这些基于有限数量受试者的研究表明，高度补充的控制低能量饮食是一种安全有效的治疗糖尿病和肥胖的方法，可以显著降低体重、血压、血糖和血脂水平。这种饮食可能是中度至明显肥胖的非胰岛素依赖型糖尿病患者的最佳初始治疗方法。
We evaluated the safety and efficacy of a highly supplemented controlled low-energy (1764 kJ [420 kcal]) diet in the treatment of non-insulin-dependent diabetes and obesity. Six obese, diabetic women ranging from 143% to 297% of ideal body weight were studied in a metabolic ward for 48 days. The subjects ingested a weight-maintenance diet during an eight-day control period followed by 40 days of an experimental diet containing 1764 kJ (420 kcal) of a mixture of protein (43% of energy intake), carbohydrates (51%), and fat (6%), supplemented with minerals, trace elements, and vitamins. The subjects were monitored for balances of nitrogen and minerals, as well as for the appearance of cardiac arrhythmias by 24-hour electrocardiographic recordings. Weight loss was rapid and sustained and averaged 10.1% .+-. 0.8% over 40 days. Fasting plasma glucose levels declined from 16.2 .+-. 1.9 mmol/L (293 .+-. 36 mg/dL) to 6.9 .+-. 0.8 mmol/L (126 .+-. 16 mg/dL) by day 35. Similarly, hemoglobin A1c levels fell from 0.11 .+-. 0.009 (11.2% .+-. 0.9%) to 0.8 .+-. 0.001 (8.2% .+-. 1.1%). Urinary C-peptide levels declined from 62.2 .+-. 15.6 nmol/48 h to 20.0 .+-. 5.9 nmol/48 h days 39 to 40 and paralleled the decline in plasma glucose values, the majority of which occurred in the first seven days. Concentrations of serum cholesterol and triglycerides decreased. Balances for nitrogen, potassium, and magnesium were negative at -1.7 g/24 h, -2.2 mEq/24 h, and -2.9 mg/dL, respectively. Blood pressure decreased without orthostasis. Resting metabolic rate fell a mean of 18% but remained within normal limits. Triiodothyronine levels also declined. Twenty-four-hour ambulatory electrocardiographic readings disclosed no significant bradyarrhythmia or tachyarrhythmia for any patient. These studies, based on a limited number of subjects, demonstrate that a highly supplemented controlled low-energy diet is a safe and efficacious treatment for diabetes and obesity, leading to a significant decreases in weight, blood pressure, and levels of plasma glucose and plasma lipids. Such diets may be the optimal initial treatment of moderate to markedly obese patients with non-insulin-dependent diabetes.