强化生活方式干预对2型糖尿病患者血糖控制的影响:随机临床试验
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
概括
与标准治疗相比,对2型糖尿病的强化生活方式干预没有达到同等的血糖控制,但显示出改善的趋势. 这种干预措施显著减少了降血糖药物的需要.
科学领域:
- 内分泌学和新陈代谢
- 临床研究
- 糖尿病管理
背景情况:
- 在2型糖尿病中保持血糖控制对于预防并发症至关重要.
- 在维持长期血糖控制方面,强化生活方式干预的有效性仍在研究中.
研究的目的:
- 评估2型糖尿病患者的密集生活方式干预是否达到同等的血糖控制与标准治疗.
- 确定生活方式干预是否减少了降血糖药物的需要.
主要方法:
- 一个随机的,评估者盲目的,单中心研究包括98名在10年内被诊断为2型糖尿病的成年人.
- 参与者被分配到一个强化生活方式干预 (有氧和抵抗训练,饮食计划) 或标准护理12个月.
- 主要结局是血红蛋白A1c (HbA1c) 的变化,并对药物减少进行二次分析.
主要成果:
- 生活方式干预不符合HbA1c变化的预规定的等效标准 (平均差异为- 0. 26%,P=. 15).
- 与标准治疗组相比,生活方式组 (73. 5%) 服用降血糖药物的比例显著增加 (26. 4%).
- 在生活方式组中,不良反应更频繁,主要是肌肉骨不适和轻度低血糖.
结论:
- 强化生活方式干预没有显示血糖控制的等价性,但显示出有益的趋势.
- 这种干预导致了显著的降血糖药物的使用.
- 需要进一步的研究来证实其优越性,通用性和长期耐用性.
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