Preventative Health Unit, Baker IDI Heart and Diabetes Institute and Nutrition & Dietetics Unit, Monash University, Melbourne, Victoria, Australia.
J Hum Nutr Diet. 2010 Aug;23(4):344-52. doi: 10.1111/j.1365-277X.2010.01061.x. Epub 2010 Mar 23.
Individuals with impaired fasting glucose or impaired glucose tolerance are at high risk of progression to type 2 diabetes. Lifestyle modification through change to diet and exercise habit has considerable potential to prevent or delay the onset of this disease.
A systematic literature search was undertaken of Medline, EMBASE, the Cochrane library and the Cumulative Index to Nursing and Allied Health Literature for journal articles relevant to the question of whether type 2 diabetes can be prevented by lifestyle change.
Four cohort studies in a total of 4864 high risk individuals followed for a period of 2.5-6 years were identified. These showed that lifestyle change may reduce the incidence of type 2 diabetes by 28-59%. Moreover, follow-up studies also indicate that diabetes incidence rates continue to be depressed many years after the discontinuation of a lifestyle intervention. Evidence from a meta-analysis confirms this evidence and suggests that it would be necessary to treat 6.4 (95% confidence interval 5.0-8.4) individuals to prevent or delay one case of diabetes through lifestyle intervention. An examination of weight loss diets (low fat, high protein or Mediterranean) suggests each may be effective but each has limitations requiring care in food selection. Evidence also suggests that the maintenance of weight loss also requires regular exercise with an additional expenditure of approximately 8.4 MJ week(-1) (2000 kcal week(-1)).
Diabetes can be prevented by lifestyle change. The challenge is to develop public health approaches to support individuals with respect to incorporating the lifestyle changes needed to reduce the risk of diabetes into their everyday life.
空腹血糖受损或糖耐量受损的个体患 2 型糖尿病的风险很高。通过改变饮食和运动习惯来进行生活方式的改变，具有很大的潜力来预防或延缓这种疾病的发生。
对 Medline、EMBASE、Cochrane 图书馆和 Cumulative Index to Nursing and Allied Health Literature 进行了系统的文献检索，以寻找与生活方式改变是否可以预防 2 型糖尿病这一问题相关的期刊文章。
共确定了四项队列研究，总计 4864 名高危个体随访了 2.5-6 年。这些研究表明，生活方式的改变可能使 2 型糖尿病的发病率降低 28-59%。此外，随访研究还表明，在生活方式干预停止多年后，糖尿病的发病率仍持续下降。荟萃分析的证据证实了这一证据，并表明通过生活方式干预，需要治疗 6.4（95%置信区间 5.0-8.4）个人，才能预防或延迟一例糖尿病的发生。对低脂肪、高蛋白或地中海饮食等减肥饮食的研究表明，每种饮食都可能有效，但每种饮食都有局限性，需要在食物选择上谨慎。证据还表明，保持体重减轻也需要定期运动，每周额外消耗约 8.4MJ（2000 卡路里）。
通过生活方式的改变可以预防糖尿病。挑战在于制定公共卫生方法，支持个人将降低糖尿病风险所需的生活方式改变融入日常生活中。
