Davies M J, Tringham J R, Troughton J, Khunti K K
Department of Diabetes, University Hospitals of Leicester NHS Trust, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, UK.
Diabet Med. 2004 May;21(5):403-14. doi: 10.1111/j.1464-5491.2004.01176.x.
Abstract Type 2 Diabetes mellitus (T2DM) is a complex metabolic, multifactorial disease, which affects the quality, quantity and style of life. People with T2DM have a life expectancy that can be shortened by as much as 15 years, with up to 75% dying of macrovascular complications. To reduce the impact of T2DM in the 21st century, we need an approach that not only optimally treats the person with established diabetes but also prevents diabetes from occurring in the first place. The best evidence for prevention of diabetes is for interventions that target individuals at highest risk. Targeting patients who have impaired glucose tolerance with lifestyle changes including physical activity and dietary factors has been shown to be effective in the Chinese, North American and Finnish populations. In order for such lifestyle interventions to be successful in other populations, they need to be culturally sensitive, individualized and sustained. Some pharmacological agents including metformin and acarbose have also been shown to be effective, although the profile of those who respond is different. There continues to be a need to develop and evaluate interventions that target communities and populations at risk in a UK setting.
摘要 2 型糖尿病（T2DM）是一种复杂的代谢性多因素疾病，会影响生活质量、数量和方式。2 型糖尿病患者的预期寿命可能缩短多达 15 年，高达 75%的患者死于大血管并发症。为了在 21 世纪减少 2 型糖尿病的影响，我们需要一种方法，不仅要对已确诊糖尿病的患者进行最佳治疗，还要从一开始就预防糖尿病的发生。预防糖尿病的最佳证据是针对高危个体的干预措施。在中国、北美和芬兰人群中，通过包括体育活动和饮食因素在内的生活方式改变来针对糖耐量受损的患者已被证明是有效的。为了使这种生活方式干预措施在其他人群中取得成功，它们需要具有文化敏感性、个性化且可持续。一些药物制剂，包括二甲双胍和阿卡波糖，也已被证明是有效的，尽管有反应者的特征有所不同。在英国的环境中，仍然需要开发和评估针对有风险的社区和人群的干预措施。
