新たに診断された2型糖尿病の患者における食事または食事と運動加減の通常のケアとの比較:Early ACTIDランダム化対照試験
R C Andrews1, A R Cooper, A A Montgomery
1School of Clinical Sciences, University of Bristol, Bristol, UK. rob.andrews@bristol.ac.uk
Lancet (London, England)
|June 28, 2011
まとめ
2型糖尿病の診断を受けた後の集中的な食事の変化は,血糖のコントロールを改善します. 身体活動の追加は,糖尿病の管理に追加的な利点を提供しなかった.
科学分野:
- エンドクリノロジー エンドクリノロジー
- メタボリック疾患
- クリニック・トライアル 臨床試験
背景:
- ライフスタイルの介入は,2型糖尿病 (T2DM) の管理に不可欠です.
- 限定的な大規模試験では,診断後の食事と運動介入の有効性を比較しています.
- 早期のライフスタイルの変化が,血糖制御と血圧に与える影響を調査することが不可欠です.
研究 の 目的:
- T2DM患者の通常のケアと比較して,集中的な食事介入の有効性を評価する.
- 集中的なダイエット介入に対する身体活動プログラムによる追加的利益を評価する.
- これらの介入が血圧とグルコース濃度に与える影響を決定する.
主な方法:
- ランダム化比較試験は,前5〜8ヶ月前にT2DMと診断された30〜80歳の成人を対象に実施されました.
- 参加者は通常のケア,集中的なダイエット介入,またはダイエットと身体活動に割り当てられました.
- プライマリエンドポイントは,6ヶ月後のグリケートヘモグロビンA1c (HbA1c) と血圧の改善でした.
主要な成果:
- ダイエットとダイエット+アクティビティグループは,対照群と比較して6ヶ月でHbA1cの有意な改善を示しました.
- これらの血糖コントロールの改善は,糖尿病の薬剤の使用が減少したにもかかわらず,12ヶ月後に持続しました.
- 体重とインスリン抵抗性が改善した一方で,血圧はすべてのグループで同様のままでした.
結論:
- 2型糖尿病の診断直後に開始された集中的なダイエット介入は,血糖コントロールを効果的に改善します.
- ダイエット介入と並行して身体活動プログラムを組み込むことは,追加の血糖値の改善をもたらさなかった.
- 早期の,集中的な食事の変化は,T2DMの管理のための重要な戦略です.
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