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降低糖尿病前期进展为2型糖尿病风险的治疗干预措施。

Therapeutic interventions to reduce the risk of progression from prediabetes to type 2 diabetes mellitus.

作者信息

Portero McLellan Katia Cristina, Wyne Kathleen, Villagomez Evangelina Trejo, Hsueh Willa A

机构信息

Department of Public Health, School of Medicine, Sao Paulo State University, Botucatu, SP, Brazil.

Division of Diabetes, Obesity and Lipids, Department of Medicine, The Methodist Hospital Diabetes and Metabolism Institute, and the Houston Methodist Research Institute, Weill Cornell Medical College, Houston, TX, USA.

出版信息

Ther Clin Risk Manag. 2014 Mar 20;10:173-88. doi: 10.2147/TCRM.S39564. eCollection 2014.

Abstract

Clinical trials have demonstrated that it is possible to prevent diabetes through lifestyle modification, pharmacological intervention, and surgery. This review aims to summarize the effectiveness of these various therapeutic interventions in reducing the risk of progression of prediabetes to diabetes, and address the challenges to implement a diabetes prevention program at a community level. Strategies focusing on intensive lifestyle changes are not only efficient but cost-effective and/or cost-saving. Indeed, lifestyle intervention in people at high risk for type 2 diabetes mellitus (T2DM) has been successful in achieving sustained behavioral changes and a reduction in diabetes incidence even after the counseling is stopped. Although prediabetes is associated with health and economic burdens, it has not been adequately addressed by interventions or regulatory agencies in terms of prevention or disease management. Lifestyle intervention strategies to prevent T2DM should be distinct for different populations around the globe and should emphasize sex, age, ethnicity, and cultural and geographical considerations to be feasible and to promote better compliance. The translation of diabetes prevention research at a population level, especially finding the most effective methods of preventing T2DM in various societies and cultural settings remains challenging, but must be accomplished to stop this worldwide epidemic.

摘要

临床试验表明,通过生活方式改变、药物干预和手术可以预防糖尿病。本综述旨在总结这些不同治疗干预措施在降低糖尿病前期进展为糖尿病风险方面的有效性,并探讨在社区层面实施糖尿病预防计划所面临的挑战。侧重于强化生活方式改变的策略不仅有效,而且具有成本效益和/或节省成本。事实上,对2型糖尿病(T2DM)高危人群进行生活方式干预已成功实现持续的行为改变,即使在咨询停止后糖尿病发病率也有所降低。尽管糖尿病前期与健康和经济负担相关,但在预防或疾病管理方面,干预措施或监管机构尚未对其给予充分关注。预防T2DM的生活方式干预策略应因全球不同人群而异,并应强调性别、年龄、种族以及文化和地理因素,以便可行并促进更好的依从性。在人群层面开展糖尿病预防研究的转化工作,尤其是在各种社会和文化背景下找到预防T2DM的最有效方法,仍然具有挑战性,但必须完成这项工作以阻止这一全球流行疾病。

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