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2型糖尿病的预防与治疗:生活方式、天然产物及药物干预的当前作用

Prevention and treatment of type 2 diabetes: current role of lifestyle, natural product, and pharmacological interventions.

作者信息

Hays Nicholas P, Galassetti Pietro R, Coker Robert H

机构信息

Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States.

出版信息

Pharmacol Ther. 2008 May;118(2):181-91. doi: 10.1016/j.pharmthera.2008.02.003. Epub 2008 Mar 2.

Abstract

Common complications of type 2 diabetes (T2D) are eye, kidney and nerve diseases, as well as an increased risk for the development of cardiovascular disease and cancer. The overwhelming influence of these conditions contributes to a decreased quality of life and life span, as well as significant economic consequences. Although obesity once served as a surrogate marker for the risk of T2D, we know now that excess adipose tissue secretes inflammatory cytokines that left unchecked, accelerate the progression to insulin resistance and T2D. In addition, excess alcohol consumption may also increase the risk of T2D. From a therapeutic standpoint, lifestyle interventions such as dietary modification and/or exercise training have been shown to improve glucose homeostasis but may not normalize the disease process unless weight loss is achieved and increased physical activity patterns are established. Furthermore, utilization of natural products may serve as a significant adjunct in the fight against insulin resistance but further research is needed to ascertain their validity. Since it is clear that pharmaceutical therapy plays a significant role in the treatment of insulin resistance, this review will also discuss some of the newly developed pharmaceutical therapies that may work in conjunction with lifestyle interventions, and lessen the burden of behavioral change as the only strategy against the development of T2D.

摘要

2型糖尿病(T2D)的常见并发症包括眼部、肾脏和神经疾病,以及患心血管疾病和癌症风险的增加。这些病症的巨大影响导致生活质量下降、寿命缩短,以及重大的经济后果。虽然肥胖曾作为T2D风险的替代指标,但我们现在知道,过多的脂肪组织会分泌炎症细胞因子,若不加以控制,会加速向胰岛素抵抗和T2D的进展。此外,过量饮酒也可能增加患T2D的风险。从治疗角度来看,饮食调整和/或运动训练等生活方式干预已被证明可改善葡萄糖稳态,但除非实现体重减轻并建立增加体力活动的模式,否则可能无法使疾病进程正常化。此外,天然产物的利用可能在对抗胰岛素抵抗方面发挥重要辅助作用,但需要进一步研究以确定其有效性。由于药物治疗在胰岛素抵抗的治疗中显然起着重要作用,本综述还将讨论一些新开发的药物治疗方法,这些方法可能与生活方式干预协同作用,并减轻仅将行为改变作为预防T2D发生的唯一策略的负担。

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