Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis
Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis
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DOI：
10.1136/bmj.39063.689375.55
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发表时间：
2007-02-10
影响因子：
105.7
通讯作者：
Khunti, Kamlesh
中科院分区：
文献类型：
--
作者：
Gillies, Clare L.;Abrams, Keith R.;Khunti, Kamlesh
目的量化药物和生活方式干预对预防或延缓糖耐量减低人群2型糖尿病的有效性。数据来源Medline、Embase和科克伦图书馆，检索截止2006年7月。专家意见征求和参考名单确定的研究和任何相关的发表reviews checked.Study选择随机对照试验，评估干预措施，以延迟或预防2型糖尿病的个体与impaired glucose tolerance.Results 21项试验符合纳入标准，其中17，8084名参与者与impaired glucose tolerance，报告的结果，在足够详细的纳入荟萃分析。根据荟萃分析，合并风险比为0.51（95%置信区间0.44至0.60）生活方式干预与标准建议，0.70（0.62 - 0.79）口服糖尿病药物v对照，0.44（0.28 - 0.69）为奥利司他v对照组，0.32（0.03 - 3.07）为中药降糖补肾方v标准糖尿病建议组。这些对应于生活方式的获益（NNTB）和危害（NNTH）治疗所需的数字为6.4（95%可信区间，NNTB 5.0至NNTB 8.4），口服糖尿病药物为10.8（NNTB 8.1至NNTB 15.0），奥利司他5.4（NNTB 4.1至NNTB 7.6），降糖补肾4.0结论：生活方式和药物干预可降低糖耐量受损人群进展为2型糖尿病的发生率。生活方式干预似乎至少与药物治疗一样有效。
Objective To quantify the effectiveness of pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance.Data sources Medline, Embase, and the Cochrane library searched up to July 2006. Expert opinions sought and reference lists of identified studies and any relevant published reviews checked.Study selection Randomised controlled trials that evaluated interventions to delay or prevent type 2 diabetes in individuals with impaired glucose tolerance.Results 21 trials met the inclusion criteria, of which 17, with 8084 participants with impaired glucose tolerance, reported results in enough detail for inclusion in the meta-analyses. From the meta-analyses the pooled hazard ratios were 0.51 (95% confidence interval 0.44 to 0.60) for lifestyle interventions v standard advice, 0.70 (0.62 to 0.79) for oral diabetes drugs v control, 0.44 (0.28 to 0.69) for orlistat v control, and 0.32 (0.03 to 3.07) for the herbal remedy jiangtang bushen recipe v standard diabetes advice. These correspond to numbers needed to treat for benefit (NNTB) and harm (NNTH) of 6.4 for lifestyle (95% credible interval, NNTB 5.0 to NNTB 8.4), 10.8 for oral diabetes drugs (NNTB 8.1 to NNTB 15.0), 5.4 for orlistat (NNTB 4.1 to NNTB 7.6), and 4.0 for jiangtang bushen (NNTH 16.9 to NNTB 24.8).Conclusions Lifestyle and pharmacological interventions reduce the rate of progression to type 2 diabetes in people with impaired glucose tolerance. Lifestyle interventions seem to be at least as effective as drug treatment.