Development of interventional program in health education for pre-diabetes mellitus

由于糖尿病在日本的患病率越来越高；自2000年以来，我们开展了一项基于健康教育和自我决定的肥胖干预计划。我们采用了基于学习原理的行为方案来加强饮食和运动的自我控制。该计划的目标是减掉1.0kg的体重，并减少10%的代谢测量值。研究对象为123名有身体质量的居民。体重指数（BMI） 26.1±3.2，年龄57.2±8.1岁，岛根县居民，2006-2007年自愿参加本研究。行为干预导致参与者每天能量摄入显著减少（-483kcal, -22%），能量消耗显著增加（146kcal, 6%）。干预导致体重减轻显著差异（-2.8kg）。通过干预，人体测量参数在BMI（4.2%）、腰围（4.2%）、收缩压（2.9%）和血脂（如总胆固醇（5.1%）、甘油三酯（22.0%））方面存在显著差异。为参与者。口服糖耐量试验（OGTT）的参与者人数因干预而改变，非糖耐量（NGT）增加（n=57至79），空腹血糖受损（IFG）增加（n=6至11），糖耐量受损（IGT）减少（n=29至14），IFG+IGT增加（n=8至9），2型糖尿病（T2DM）减少（n=14至10）。JOT患者2小时血糖（161mg/dl ~ 135mg/dl）和30分钟胰岛素（42.8μU/ml ~ 48.0μU/ml）差异显著。此外，T2DM在稳态模型评估（HOMA-IR）（2.3至L4）、30分钟葡萄糖（265mg/dl至223mg/dl）和2小时葡萄糖（253mg/dl至189mg/dl）方面也存在显著差异。本研究提示干预方案对胰岛素抵抗有改善作用，对糖尿病前期的早期治疗有一定效果。

Since the prevalence of diabetes mellitus are getting increase in Japanese; we conducted to develop an intervention al program for obesity based on health education and self-determination from 2000. We adopted the behavioral program to strengthen self-control of diet and exercise based on learning principles. Objectives of the program were to lose 1.0kg of weight and to reduce 10% of metabolic measurement values.Subjects were 123 residents with Body Mass. Index (BMI) of 26.1± 3.2, aged 57.2±8.1 years in Shimane Prefecture, voluntarily participated in the present study in 2006-2007. The behavioral intervention induced significant decrease s for intakes of energy (-483kcal, -22%), and increase for consumption of energy (146kcal, 6%) per day for participants. The intervention induced a significant difference in weight-loss (-2.8kg). Significant differences of anthropometric parameters were found in BMI (4.2%), waist circumference (4.2%), systolic blood pressure (2.9%), and lipid profile, such as total cholesterol (5.1%), triglyceride (22.0%) by the intervention. For participants.The participant numbers identified oral glucose tolerance test (OGTT) changed by the intervention, non glucose tolerance (NGT) increased (n=57 to 79), impaired fasting glucose (IFG) increased(n=6 to 11), impaired glucose tolerance (IGT) decreased(n=29 to 14), IFG+IGT increased (n=8 to 9) and type 2 diabetes mellitus (T2DM) decreased (n=14 to 10). Individuals with JOT showed significant differences in 2-h glucose (161mg/dl to 135mg/dl) and 30-min insulin (42.8μU/ml to 48.0μU/ml). also T2DM showed significant differences in homeostasis model assessment (HOMA-IR) (2.3 to L4), 30-min glucose (265mg/dl to 223mg/dl) and 2-h glucose (253mg/dl to 189mg/dl).This investigation suggests that the interventional program have an improvement of insulin resistance and an effect on early treatment for pre-diabetes mellitus.