2型糖尿病患者の血糖コントロールに対する集中的なライフスタイル介入の効果: ランダム化臨床試験
Mette Yun Johansen1,2, Christopher Scott MacDonald1,2,3, Katrine Bagge Hansen1,2
1Centre of Inflammation and Metabolism, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
JAMA
|August 16, 2017
まとめ
2型糖尿病に対する集中的なライフスタイルの介入は,標準治療と比較して同等の血糖制御を達成することはできませんでしたが,改善の傾向を示しました. この介入によって 血糖を低下させる薬の必要性が著しく減少しました
科学分野:
- 内分泌学と代謝
- 臨床研究
- 糖尿病 管理
背景:
- 2型糖尿病では,血糖値のコントロールを保つことが,合併症の予防に不可欠です.
- 長期的に血糖コントロールを維持するための集中的なライフスタイルの介入の有効性は調査中です.
研究 の 目的:
- 2型糖尿病患者の標準治療と比較して,集中的なライフスタイルの介入によって同等の血糖コントロールが達成されるかどうかを評価する.
- ライフスタイルの介入によって 血糖値を下げる薬の必要性が減少するかどうかを判断する.
主な方法:
- ランダム化され,評価者盲検され,単一センターでの研究では,10年以内に診断された2型糖尿病の98人の成人が参加しました.
- 参加者は12ヶ月間,集中的なライフスタイルの介入 (エアロビックとレジスタンストレーニング,食事計画) または標準的なケアに割り当てられました.
- 主要評価は,同等性のためのヘモグロビンA1c (HbA1c) の変化であり,薬剤の減少に関する二次分析でした.
主要な成果:
- ライフスタイルの介入は,HbA1c変化の予め指定された同等性基準を満たさなかった (平均差は- 0. 26%,P=. 15).
- 標準治療群 (26. 4%) と比較すると,ライフスタイル群 (73. 5%) の割合が著しく減少した.
- 主に運動器系不快感と軽度の低血糖症でした.
結論:
- 集中的なライフスタイルの介入は,血糖値のコントロールにおいて同値を示さなかったが,有益な傾向を示した.
- この介入により,血糖を低下させる薬の使用が著しく減少しました.
- 優越性,一般化性,長期的な耐久性を確認するためにさらなる研究が必要である.
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