Department of Medicine, Division of Endocrinology, Université de Sherbrooke, Centre de Recherche Clinique Étienne-LeBel, Sherbrooke, Qc J1H 5N4 Quebec, Canada.
Diabetes Metab. 2011 Nov;37(5):410-8. doi: 10.1016/j.diabet.2011.01.003. Epub 2011 Apr 13.
To compare the effectiveness and cost of two lifestyle-modification programmes in individuals at high risk of developing type 2 diabetes.
Forty-eight men and women with a body mass index ≥27 kg/m(2) and prediabetes were randomly assigned to either a 1-year interdisciplinary intervention including individual counseling every 6 weeks and 25 group seminars (group I; n=22) or a group intervention comprising seminars only (group G; n=26). These interventions were compared in terms of weight loss and improvement of anthropometric measures, metabolic variables and costs.
Participants in group I lost an average of 4.9 kg (95% CI: -7.3, -2.4; P<0.01) and 5 cm in waist circumference (95% CI: -7.0, -3.0; P<0.01), whereas no significant change was noted in those assigned to group G. Among the participants in group I, 50 and 27% lost at least 5 and 10% of their initial weight, respectively, compared with only 12 and 4%, respectively, in group G. Fasting glucose, 2-hour glucose and lipid profiles improved significantly in group I, and no participant (zero on 22) developed diabetes compared with 11.5% (3/26) in group G. Most participants (nine on 11) with impaired fasting glucose in group I returned to normal. The direct cost of the individual intervention was estimated to be $733.06/year per subject compared with $81.36/year per subject for the group intervention.
This study demonstrates that a low-cost, moderate-intensity, individual interdisciplinary approach combined with group seminars leads to clinically significant weight loss and metabolic improvement in people with prediabetes. Group seminars alone were not effective in this population (www.ClinicalTrial.gov, Identifier: NCT00991549).
比较两种生活方式干预方案在有发展为 2 型糖尿病风险的个体中的有效性和成本。
48 名体质指数（BMI）≥27kg/m²且有前驱糖尿病的男女被随机分配到为期 1 年的多学科干预组，该组包括每 6 周进行一次个体咨询和 25 次小组研讨会（组 I；n=22），或参加仅包含小组研讨会的小组干预组（组 G；n=26）。比较这两种干预在体重减轻和改善人体测量指标、代谢变量以及成本方面的效果。
组 I 的参与者平均体重减轻了 4.9kg（95%置信区间：-7.3，-2.4；P<0.01）和 5cm 腰围（95%置信区间：-7.0，-3.0；P<0.01），而分配到组 G 的参与者则没有显著变化。在组 I 中，50%和 27%的参与者分别减轻了至少 5%和 10%的初始体重，而组 G 中这一比例分别仅为 12%和 4%。组 I 中的空腹血糖、2 小时血糖和血脂谱均显著改善，且无参与者（22 人中的 0 人）发展为糖尿病，而组 G 中则有 11.5%（26 人中的 3 人）发生了这种情况。组 I 中大多数（11 人中的 9 人）空腹血糖受损的患者恢复正常。个体干预的直接成本估计为每个受试者每年 733.06 美元，而小组干预为每个受试者每年 81.36 美元。
这项研究表明，一种低成本、中等强度、个体多学科方法结合小组研讨会可使前驱糖尿病患者的体重显著减轻和代谢改善。单纯的小组研讨会在该人群中无效（www.ClinicalTrials.gov，注册号：NCT00991549）。
