JAMA Intern Med:生活方式干预对糖尿病前期人群糖尿病风险的影响

2020-11-09 MedSci原创 MedSci原创

对于血糖风险较高的非糖尿病人群,接受预防生活方式干预可降低进展为糖尿病的风险,但医疗参与的强化干预并未使风险进一步降低

近一半的老年人口患有糖尿病或血糖风险较高,但对于大多数血糖风险较高人群,尚缺乏有效的II型糖尿病预防干预措施的证据。近日研究人员考察了生活方式干预对血糖风险较高人群II型糖尿病风险的影响。
 
Norfolk Diabetes Prevention研究是一项平行、三臂、随机临床试验,从2011年8月到2019年1月,在英格兰东部135个初级保健机构和8个干预地点进行,为期46个月。12778人血糖风险较高人群参与,参与者单纯的空腹血糖水平升高(110-126 mg/dL),或糖化血红蛋白水平升高(6.0-6.5%,非糖尿病性高血糖)伴有空腹血糖水平升高(100-110 mg/dL)。随机分为常规护理(CON)组、基于理论的生活方式干预组,包括6个核心和最多15个维持期干预(INT),或在糖尿病预防师、经系统训练的II型糖尿病预防志愿者(INT-DPM)帮助下进行的生活干预(INT-DPM)。研究的主要终点为II型糖尿病发病率。
 
1028名参与者,其中INT组424人,INT-DPM组426人,CON组178名。平均年龄为65.3岁,平均体重指数为31.2,平均随访24.7个月。共有156名参与者发展为II型糖尿病,其中,CON组39名患者(22.8%),INT组55名患者(13.7%),INT-DPM组的62名患者(15.0%)。2个干预组间主要结果无显著性差异(比值比[OR]=1.14),与对照组相比,干预组的II型糖尿病风险明显降低(INT组OR=0.54;INT-DPM组为0.61)。
 
研究认为,对于血糖风险较高的非糖尿病人群,接受预防生活方式干预可降低进展为糖尿病的风险,但医疗参与的强化干预并未使风险进一步降低。
 
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    2022-04-18 ms1000001687352890

    原来感谢分享

    0

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    2020-11-25 ms2792216160141132

    学习到很多~~~~

    0

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  5. [GetPortalCommentsPageByObjectIdResponse(id=1212126, encodeId=e10c121212621, content=原来感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5db65480276, createdName=ms1000001687352890, createdTime=Mon Apr 18 10:44:47 CST 2022, time=2022-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=902020, encodeId=c124902020ce, content=学习到很多~~~~, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eo8USjX7HG2kSs8MXoJicX9vHqP791wzDdGm2m0yOI7VYNZsJ25YkFXHBatjLpXLBkibSV4WdzB0afw/132, createdBy=55902439039, createdName=ms2792216160141132, createdTime=Wed Nov 25 05:02:17 CST 2020, time=2020-11-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900090, encodeId=b42b900090a1, content=<a href='/topic/show?id=4f77e665253' target=_blank style='color:#2F92EE;'>#糖尿病#</a><a href='/topic/show?id=405269141c9' target=_blank style='color:#2F92EE;'>#生活方式#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=270, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76652, encryptionId=4f77e665253, topicName=糖尿病), TopicDto(id=69141, encryptionId=405269141c9, topicName=生活方式)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Wed Nov 18 09:34:11 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610782, encodeId=e4ae1610e822f, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Wed Nov 11 11:52:46 CST 2020, time=2020-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=898338, encodeId=feaa8983389d, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue Nov 10 21:38:20 CST 2020, time=2020-11-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036334, encodeId=13e41036334bb, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Mon Nov 09 23:52:46 CST 2020, time=2020-11-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043387, encodeId=d1f7104338ea3, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Mon Nov 09 23:52:46 CST 2020, time=2020-11-09, status=1, ipAttribution=)]
    2020-11-10 1209e435m98(暂无昵称)

    学习了,谢谢分享

    0

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    2020-11-09 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1212126, encodeId=e10c121212621, content=原来感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5db65480276, createdName=ms1000001687352890, createdTime=Mon Apr 18 10:44:47 CST 2022, time=2022-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=902020, encodeId=c124902020ce, content=学习到很多~~~~, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eo8USjX7HG2kSs8MXoJicX9vHqP791wzDdGm2m0yOI7VYNZsJ25YkFXHBatjLpXLBkibSV4WdzB0afw/132, createdBy=55902439039, createdName=ms2792216160141132, createdTime=Wed Nov 25 05:02:17 CST 2020, time=2020-11-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900090, encodeId=b42b900090a1, content=<a href='/topic/show?id=4f77e665253' target=_blank style='color:#2F92EE;'>#糖尿病#</a><a href='/topic/show?id=405269141c9' target=_blank style='color:#2F92EE;'>#生活方式#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=270, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76652, encryptionId=4f77e665253, topicName=糖尿病), TopicDto(id=69141, encryptionId=405269141c9, topicName=生活方式)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Wed Nov 18 09:34:11 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610782, encodeId=e4ae1610e822f, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Wed Nov 11 11:52:46 CST 2020, time=2020-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=898338, encodeId=feaa8983389d, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue Nov 10 21:38:20 CST 2020, time=2020-11-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036334, encodeId=13e41036334bb, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Mon Nov 09 23:52:46 CST 2020, time=2020-11-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043387, encodeId=d1f7104338ea3, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Mon Nov 09 23:52:46 CST 2020, time=2020-11-09, status=1, ipAttribution=)]
    2020-11-09 misszhang

    谢谢MedSci提供最新的资讯

    0

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糖尿病是一组由多病因引起的以慢性高血糖为特征的终身性代谢性疾病。其中,2型糖尿病患者更容易患循环系统疾病、痴呆症、癌症以及骨病等疾病。尽管治疗该疾病的药物不断出现,但改变生活方式仍然是治疗的基石。

Sci Adv:肥胖、糖尿病、心血管疾病等,是饮食与身体“不匹配”的结果?

该研究表明,从传统田园生活转向现代西方饮食的个体,健康状况普遍不佳;而且,终身居住在城市的居民将经历最大的心血管疾病风险。