Dietary treatment and long-term weight less and maintenance in type 2 diabetes
Dietary treatment and long-term weight less and maintenance in type 2 diabetes
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DOI：
10.1038/oby.2001.141
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发表时间：
2001-11-01
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影响因子：
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通讯作者：
Hensrud, DD
中科院分区：
文献类型：
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作者：
Hensrud, DD
体重增加，特别是腹部重量增加，与患2型糖尿病的风险增加有关，80%的2型糖尿病患者超重或肥胖。在没有糖尿病的肥胖人群中，减肥和维持体重是具有挑战性的，数据表明，对于患有糖尿病的肥胖人群来说，这可能更难做到。对糖尿病患者进行了至少一年的随访，评估了各种减肥策略，结果喜忧参半。节食在促进最初的体重减轻方面最有效。能量限制将在开始的几天内改善血糖控制，而不是体重减轻。由于能量限制的放松，饮食疗法对血糖控制的效果随着时间的推移而恶化，即使在部分体重保持的情况下也是如此。饮食结构对血糖控制几乎没有影响，与总卡路里无关。低卡路里饮食会导致更好的初始体重减轻和血糖控制，但长期效果并不比适度治疗更好。使用预制膳食和液体膳食替代品的研究的初步结果表明，减肥和血糖控制与传统饮食治疗相当。综合生活方式疗法，包括饮食、锻炼和行为矫正，可以在10到20周内导致类似于2到10公斤的体重减轻，一年后恢复到最初体重的三分之一到一半。在体重减轻一年后，血糖控制的净改善通常很小。需要使用这些和其他方法的创造性策略来改善2型糖尿病患者的长期减肥、体重维持和血糖控制。由于肥胖症和2型糖尿病的流行率不断上升，还需要在初级预防方面作出更大努力。
Increasing body weight, particularly abdominal weight, is associated with increasing risk for type 2 diabetes, and 80% of people with type 2 diabetes are overweight or obese. Weight loss and maintenance are challenging in the obese population without diabetes, and data suggest that this may be more difficult in obese people with diabetes. Various weight-loss strategies with follow-up for at least I year have been evaluated in people with diabetes with mixed results. Diet is most effective in promoting initial weight loss. Energy restriction will improve glycemic control within days of initiation, independent of weight loss. There is deterioration of the effects of dietary therapy on glycemic control over time, even with partial weight maintenance, because of the relaxation of energy restriction. Diet composition has little effect on glycemic control independent of total calories. Very-low-calorie diets lead to better initial weight loss and glycemic control but yield no better longterm results than more moderate treatment. The initial results from studies using prepared meals and liquid meal replacements show that weight loss and glycemic control are comparable with conventional dietary treatment. Comprehensive lifestyle therapies, involving diet, exercise, and behavioral modification, can lead to weight losses of similar to2 to 10 kg over 10 to 20 weeks, with regain over I year of one-third to one-half of weight initially lost. The net improvement on glycemic control is usually small 1 year after weight loss. Creative strategies using these and other modalities are needed to improve long-term weight loss, weight maintenance, and glycemic control in patients with type 2 diabetes. Greater efforts in primary prevention are also needed because of the increasing prevalence of obesity and type 2 diabetes.