Diabetes Care:肥胖2型糖尿病患者的小目标:避免体重增加

2016-08-30 Moon 译 MedSci原创

推荐肥胖的糖尿病患者进行减重,但避免体重增加可能是一个更现实的目标。我们比较了保持体重 vs 体重增加的4年经济影响。 研究纳入了8154例2型糖尿病患者,在2010年进行了首次体重测量,在2013年进行了最后一次体重测量,计算了四年期间的体重差值,以及平均糖化血红蛋白(A1C)差值。根据这两个指标,将患者分为以下四组:体重变化< 5%,A1C <7%; 体重增加≥5%,A1C

推荐肥胖的糖尿病患者进行减重,但避免体重增加可能是一个更现实的目标。我们比较了保持体重 vs 体重增加的4年经济影响。

研究纳入了8154例2型糖尿病患者,在2010年进行了首次体重测量,在2013年进行了最后一次体重测量,计算了四年期间的体重差值,以及平均糖化血红蛋白(A1C)差值。根据这两个指标,将患者分为以下四组:体重变化< 5%,A1C <7%; 体重增加≥5%,A1C <7%; 体重变化< 5%,A1C ≥7%; 重增加≥5%,A1C ≥7%。研究者比较了2010-2013年间不同变化组患者的医疗成本(校正人口和临床等特征)。

无论A1C情况如何,体重变化小于5%的患者,其医疗成本降低了约400美元;相反,对于体重增加≥5%且A1C ≥7%的患者,医疗成本增加了1473美元(P < 0.001);体重增加≥5%、A1C <7%的患者也经历了医疗成本的轻度增加(387美元, NS)。

体重变化≥5%、A1C <7%的患者,4年医疗成本增加了3.3%;体重变化≥5%、A1C ≥7%的患者,4年医疗成本增加了12%。不过无论A1C情况如何,体重变化小于5%的患者,其医疗成本下降了约5%.避免体重增加可能会降低肥胖2型糖尿病患者的长期医疗成本。

原始出处:

Nichols GA.et al.Medical Care Costs Associated With Long-Term Weight Maintenance Versus Weight Gain Among Patients With Type 2 Diabetes.Diabetes Care. 2016 Aug 25. pii: dc160933. [Epub ahead of print]

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    2017-06-16 zhouqu_8
  4. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Mon Sep 05 16:43:00 CST 2016, time=2016-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=110838, encodeId=c461110838de, content=学习了,今天下午学习中成长!, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf931932042, createdName=1e0d037em49(暂无匿称), createdTime=Sun Sep 04 13:56:00 CST 2016, time=2016-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=109872, encodeId=b7e21098e2d6, content=学习了,好, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/23/ac01daf0962458a9eb8c0b1e2f6ce5bc.jpg, createdBy=04b81710322, createdName=1771ae4158m, createdTime=Fri Sep 02 21:48:00 CST 2016, time=2016-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383246, encodeId=6e0c138324656, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Thu Sep 01 05:21:00 CST 2016, time=2016-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474040, encodeId=2d2014e404007, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Thu Sep 01 05:21:00 CST 2016, time=2016-09-01, status=1, ipAttribution=)]
    2016-09-20 1e10c84am36(暂无匿称)

    文章很好,非常有益

    0

  5. 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objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/23/ac01daf0962458a9eb8c0b1e2f6ce5bc.jpg, createdBy=04b81710322, createdName=1771ae4158m, createdTime=Fri Sep 02 21:48:00 CST 2016, time=2016-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383246, encodeId=6e0c138324656, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Thu Sep 01 05:21:00 CST 2016, time=2016-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474040, encodeId=2d2014e404007, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Thu Sep 01 05:21:00 CST 2016, time=2016-09-01, status=1, ipAttribution=)]
    2016-09-12 舒心和人

    病从口入,所以要管住嘴;生命在于运动,所以要迈开腿

    0

  6. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Sep 20 22:09:00 CST 2016, time=2016-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=123869, encodeId=916412386901, content=病从口入,所以要管住嘴;生命在于运动,所以要迈开腿, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160907/IMG57D00CF1965701770.jpg, createdBy=565c1948251, createdName=舒心和人, createdTime=Mon Sep 12 19:09:00 CST 2016, time=2016-09-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=111570, encodeId=01c61115e0dc, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Mon Sep 05 16:43:00 CST 2016, time=2016-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=110838, encodeId=c461110838de, content=学习了,今天下午学习中成长!, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf931932042, createdName=1e0d037em49(暂无匿称), createdTime=Sun Sep 04 13:56:00 CST 2016, time=2016-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=109872, encodeId=b7e21098e2d6, content=学习了,好, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/23/ac01daf0962458a9eb8c0b1e2f6ce5bc.jpg, createdBy=04b81710322, createdName=1771ae4158m, createdTime=Fri Sep 02 21:48:00 CST 2016, time=2016-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383246, encodeId=6e0c138324656, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Thu Sep 01 05:21:00 CST 2016, time=2016-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474040, encodeId=2d2014e404007, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Thu Sep 01 05:21:00 CST 2016, time=2016-09-01, status=1, ipAttribution=)]
    2016-09-05 李东泽

    很好,不错,以后会多学习

    0

  7. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Sep 20 22:09:00 CST 2016, time=2016-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=123869, encodeId=916412386901, content=病从口入,所以要管住嘴;生命在于运动,所以要迈开腿, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160907/IMG57D00CF1965701770.jpg, createdBy=565c1948251, createdName=舒心和人, createdTime=Mon Sep 12 19:09:00 CST 2016, time=2016-09-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=111570, encodeId=01c61115e0dc, content=很好,不错,以后会多学习, 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objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/23/ac01daf0962458a9eb8c0b1e2f6ce5bc.jpg, createdBy=04b81710322, createdName=1771ae4158m, createdTime=Fri Sep 02 21:48:00 CST 2016, time=2016-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383246, encodeId=6e0c138324656, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Thu Sep 01 05:21:00 CST 2016, time=2016-09-01, status=1, ipAttribution=), 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    2016-09-04 1e0d037em49(暂无匿称)

    学习了,今天下午学习中成长!

    0

  8. 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objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/23/ac01daf0962458a9eb8c0b1e2f6ce5bc.jpg, createdBy=04b81710322, createdName=1771ae4158m, createdTime=Fri Sep 02 21:48:00 CST 2016, time=2016-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383246, encodeId=6e0c138324656, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Thu Sep 01 05:21:00 CST 2016, time=2016-09-01, status=1, ipAttribution=), 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    2016-09-02 1771ae4158m

    学习了,好

    0

  9. 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