Lipkin E
University of Washington, Seattle 98195-6426, USA.
J Am Diet Assoc. 1999 Mar;99(3):329-34. doi: 10.1016/s0002-8223(99)00083-8.
This review of current developments in the treatment of type 2 diabetes focuses on the achievement of normoglycemia through appropriately defined goals of diet, exercise, and drug therapy. Clinical nutritionists are central partners in the management of type 2 diabetes, and nutrition therapy is still considered the first-line therapy of choice. A nutritionist's role in the treatment at type 2 diabetes is to ensure an individualized, nutritionally adequate diet for patients, uncomplicated by episodes of hypoglycemia. In this role, clinical nutritionists must be aware of potential drug interactions with diet therapy and may be able to provide essential feedback about possible drug interactions to other members of the health care team, including nurses, pharmacists, and physicians. The role of insulin in treating type 2 diabetes is reexamined in the light of newly available oral antidiabetic agents and increasing awareness of the importance of insulin resistance and hyperinsulinemia in the development of diabetes complications. Because many patients use insulin to reduce blood glucose and glycated hemoglobin (HbA1c) to acceptable levels, management should combine diet therapy with insulin and/or 1 or 2 oral antidiabetic agents to help minimize the dose of exogenous insulin needed for glucose control.
这篇关于2型糖尿病治疗当前进展的综述聚焦于通过合理设定饮食、运动和药物治疗目标来实现血糖正常。临床营养师是2型糖尿病管理的核心伙伴，营养治疗仍被视为首选的一线治疗方法。营养师在2型糖尿病治疗中的作用是为患者确保个性化、营养充足的饮食，且不会因低血糖发作而变得复杂。在这一角色中，临床营养师必须了解与饮食治疗潜在的药物相互作用，并可能能够向包括护士、药剂师和医生在内的医疗团队其他成员提供有关可能的药物相互作用的重要反馈。鉴于新出现的口服抗糖尿病药物以及对胰岛素抵抗和高胰岛素血症在糖尿病并发症发展中的重要性的认识不断提高，胰岛素在治疗2型糖尿病中的作用被重新审视。由于许多患者使用胰岛素将血糖和糖化血红蛋白（HbA1c）降至可接受水平，管理应将饮食治疗与胰岛素和/或1种或2种口服抗糖尿病药物相结合，以帮助尽量减少控制血糖所需的外源性胰岛素剂量。
