Araki A, Ito H
Tokyo Metropolitan Geriatric Hospital, Department of Endocrinology.
Nihon Rinsho. 1999 Mar;57(3):650-6.
Diet and exercise are basic measures of treatment of diabetes mellitus. To prevent the development and progression of atherosclerotic disease as well as microangiopathy, diet management should be focused on the reductions of conventional risk factors for atherosclerosis such as hyperglycemia, dyslipidemia, and hypertension. To control the these risk factors, both total energy and fat intake should be reduced. A diet high in mono- and poly-unsaturated fatty acids, and dietary fibers are recommended to diabetic patients, but the ideal ratio of saturated, monounsaturated, and polyunsaturated fatty acids should be determined from clinical and epidemiological studies in the future. A high concentration of plasma homocysteine is a new risk factor for atherosclerotic disease in diabetic patients. To reduce plasma homocysteine, diet enriched in folate and vitamin B12 may be recommended. A high intake of flavonoid, one of antioxidants, may be also recommended in diabetic patients because of its counteraction against increased oxidative stress in diabetes mellitus. Exercise therapy is an effective measure for improving glycemic control in Type 2 diabetic patients. However, the most appropriate kinds and strength of exercise in diabetic patients with complications or elderly diabetic patients still remain unknown. The dietary regimen or exercise of diabetic patients should be determined individually according to the risk factors, complications, and psychological and socioeconomic conditions.
饮食和运动是糖尿病治疗的基本措施。为预防动脉粥样硬化疾病以及微血管病变的发生和发展，饮食管理应着重于降低动脉粥样硬化的传统危险因素，如高血糖、血脂异常和高血压。为控制这些危险因素，应减少总能量和脂肪摄入。建议糖尿病患者食用富含单不饱和脂肪酸和多不饱和脂肪酸以及膳食纤维的饮食，但饱和脂肪酸、单不饱和脂肪酸和多不饱和脂肪酸的理想比例有待未来通过临床和流行病学研究确定。高浓度血浆同型半胱氨酸是糖尿病患者动脉粥样硬化疾病的一个新危险因素。为降低血浆同型半胱氨酸水平，可以推荐食用富含叶酸和维生素B12的饮食。由于黄酮类化合物（一种抗氧化剂）能对抗糖尿病中增加的氧化应激，也可以建议糖尿病患者大量摄入。运动疗法是改善2型糖尿病患者血糖控制的有效措施。然而，有并发症的糖尿病患者或老年糖尿病患者最适宜的运动类型和强度仍不清楚。糖尿病患者的饮食方案或运动应根据危险因素、并发症以及心理和社会经济状况进行个体化确定。
