Meinders A E, Pijl H
Department of General Internal Medicine, University Hospital, Leiden, The Netherlands.
Int J Obes Relat Metab Disord. 1992 Dec;16 Suppl 4:S35-9.
Weight reduction in non-insulin dependent diabetes mellitus (NIDDM) patients improves metabolic control, reduces cardiovascular risk factors, has blood pressure lowering effects and improves the well-being of the patient. This paper describes the role of very low calorie diets (VLCD), exercise, beta-adrenergic drugs and serotoninergic agents in the treatment of overweight in NIDDM. VLCD reduce body weight and improve glucose metabolism. Physical exercise programmes in addition to dietary restriction substantially contribute to weight loss and metabolic control in NIDDM. New specific beta-adrenergic agents, exhibiting virtually no beta 1 or beta 2 activity, increase energy expenditure and weight loss probably by enhancement of the basal metabolic rate. The target tissue in humans of this beta-adrenergic effect is as yet unknown. These drugs seem to enhance weight loss when used in combination with (very) low calorie diets compared to dietary restriction alone. Serotoninergic drugs reduce body weight by decreasing appetite, in particular for carbohydrates. Furthermore these drugs seem to improve insulin receptor sensitivity.
非胰岛素依赖型糖尿病（NIDDM）患者减轻体重可改善代谢控制，降低心血管危险因素，具有降低血压的作用，并能改善患者的健康状况。本文描述了极低热量饮食（VLCD）、运动、β-肾上腺素能药物和5-羟色胺能药物在NIDDM超重患者治疗中的作用。VLCD可减轻体重并改善葡萄糖代谢。除饮食限制外，体育锻炼计划对NIDDM患者的体重减轻和代谢控制有很大帮助。新型特异性β-肾上腺素能药物几乎不表现出β1或β2活性，可能通过提高基础代谢率来增加能量消耗和减轻体重。这种β-肾上腺素能效应在人体中的靶组织尚不清楚。与单独的饮食限制相比，这些药物与（极）低热量饮食联合使用时似乎能增强体重减轻效果。5-羟色胺能药物通过降低食欲，尤其是对碳水化合物的食欲来减轻体重。此外，这些药物似乎能改善胰岛素受体敏感性。
