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从NHS2型糖尿病缓解计划的早期发现:对现实世界的实施进行前性评估
Jonathan Valabhji1, Tessa Gorton2, Emma Barron1
1Prevention and Long Term Conditions Programme, Medical Directorate, NHS England, London, UK; Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK; Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
全方位饮食替代 (TDR) 可以在现实环境中实现2型糖尿病缓解. 国家卫生服务局的2型糖尿病缓解途径 (T2DR) 计划证明了这一点,尽管缓解率低于试验.
科学领域:
- 内分泌学 在内分泌学.
- 代谢疾病 代谢疾病
- 公共卫生干预措施 公共卫生干预措施
背景情况:
- 随机对照试验表明,全方位饮食替代 (TDR) 可以诱导2型糖尿病的缓解.
- 英国国家卫生服务 (NHS) 启动了2型糖尿病缓解途径 (T2DR) 计划,这是一项使用TDR进行的大规模,现实世界的干预.
研究的目的:
- 评估NHS T2DR计划在实现2型糖尿病缓解方面的有效性.
- 评估在NHS内提供基于TDR的干预措施的可行性.
主要方法:
- 一项对T2DR计划的全国前性服务评估,涉及7540名被引用的参与者 (18-65岁) 在6年内被诊断患有2型糖尿病.
- 数据与国家糖尿病审计对HbA1c和药物数据的数据联系;主要结果:1年后2型糖尿病缓解.
主要成果:
- 在2022年1月之前开始TDR的1740名参与者中,960人 (55%) 完成了该计划,平均体重减轻9.3%.
- 在记录HbA1c的完成者中,32%的人实现了缓解 (平均体重减轻14.4%).
- 缓解率低于RCT,在现实环境中数据的确定更为有限.
结论:
- 该NHS T2DR计划表明,通过规模化的干预,可以在临床试验之外实现2型糖尿病缓解.
- 与受控研究环境相比,现实世界的实施在缓解率和数据收集方面存在挑战.
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