An intensified lifestyle intervention programme may be superior to insulin treatment in poorly controlled Type 2 diabetic patients on oral hypoglycaemic agents: results of a feasibility study
An intensified lifestyle intervention programme may be superior to insulin treatment in poorly controlled Type 2 diabetic patients on oral hypoglycaemic agents: results of a feasibility study
复制标题
DOI：
10.1111/j.1464-5491.2005.01421.x
复制
发表时间：
2005-03-01
影响因子：
3.5
通讯作者：
Birkeland, KI
中科院分区：
文献类型：
--
作者：
Aas, AM;Bergstad, I;Birkeland, KI
目的本研究的目的是评估对于口服降血糖药（OHA）血糖控制不佳的2型糖尿病患者，基于运动和饮食咨询的生活方式干预计划（i）在控制血糖方面是否与胰岛素治疗一样有效，和（ii）可以防止通常伴随胰岛素治疗的体重增加。8名接受OHA治疗的2型糖尿病受试者，HbA（1c）8-10.5%，体重指数（BMI）26-40 kg/m2，随机接受以下治疗：（i）生活方式干预（L），（ii）生活方式干预+胰岛素治疗（L+I）和（iii）单独胰岛素治疗（I）。（四分位距1.0），L、L+I和I组分别为-1.0（1.7）和-1.5（2.5）%，所有治疗组均实现了血脂变量的有益变化。治疗开始和12个月之间观察到的HbA（1c）水平变化在两组之间无显著差异（P = 0.74）。组间体重变化有显著差异（P < 0.01）：L组体重减轻中位数为-3.0（4.0）kg，L+I和I组体重增加3.5（3.4）和4.9结论生活方式干预在改善血糖控制不佳的2型糖尿病患者的血糖控制方面与胰岛素治疗一样有效，并在干预年期间导致体重减轻。然而，生活方式干预组在干预停止1年后，血糖控制恶化，体重增加。
Aims The aims of this study were to assess whether, in Type 2 diabetic patients with inadequate glycaemic control on oral hypoglycaemic agents (OHA), a lifestyle intervention programme based on exercise and diet counselling (i) was as effective as insulin treatment in controlling blood glucose, and (ii) could prevent the weight gain usually accompanying the introduction of insulin treatment.Methods Thirty-eight Type 2 diabetic subjects treated with OHA, HbA(1c) 8-10.5% and body mass index (BMI) 26-40 kg/m(2), were randomized to the following treatments: (i) lifestyle intervention (L), (ii) lifestyle intervention + insulin treatment (L+I) and (iii) insulin treatment alone (I).Results There was a reduction in HbA(1c) of -1.2 (interquartile range 1.0), -1.0 (1.7) and -1.5 (2.5)% in group L, L+I and I, respectively, and all treatment groups achieved beneficial changes in blood lipid variables. There was no significant difference between the groups in the change observed in levels of HbA(1c) between start and 12 months of treatment (P = 0.74). There was a significant difference in weight changes between groups (P < 0.01): group L reduced weight by median -3.0 (4.0) kg, groups L+I and I increased weight by 3.5 (3.4) and 4.9 (6.9) kg, respectively.Conclusions Lifestyle intervention was as effective as insulin treatment in improving glycaemic control in poorly controlled subjects with Type 2 diabetes, and resulted in weight loss during the intervention year. However, glycaemic control deteriorated and body weight increased in the lifestyle intervention group 1 year after the intervention stopped.