Kerrison George, Gillis Richard B, Jiwani Shahwar I, Alzahrani Qushmua, Kok Samil, Harding Stephen E, Shaw Ian, Adams Gary G
School of Health Sciences, Faculty of Medicine South Block, Queen's Medical Centre, University of Nottingham, Nottingham NG7 2HA, UK.
University of Nottingham, Sutton Bonington Campus, NCMH Building, Sutton Bonington, Leicestershire LE12 5RD, UK.
J Diabetes Res. 2017;2017:8493145. doi: 10.1155/2017/8493145. Epub 2017 Apr 16.
Diabetes prevalence is increasing exceptionally worldwide and with this come associated healthcare costs. The primary outcome of this systematic review was to assess glycaemic control and incidence of Type 2 diabetes mellitus (T2DM) diagnosis after exercise and dietary intervention (measured with any validated scale). The secondary outcome assessed body mass index change, weight change, and physical exercise capacity after diet and exercise intervention (measured with any validated scale). 1,780 studies were identified from searching electronic databases. Relevant studies went through a selection process. The inclusion criteria for all studies were people with prediabetes diagnosed by either impaired glucose tolerance (IGT) or impaired fasting glucose (IFG). Lifestyle adaptation reduced the incidence of diabetes development more than standard treatment. Furthermore, better glycaemic control, improved physical exercise capacity, and increased weight reduction were observed with lifestyle intervention over standard treatment. Finally, improvements over the long term deteriorated, highlighting problems with long-term adherence to lifestyle changes. Overall, cumulative incidence of diabetes is drastically reduced in the intervention groups compared to control groups (standard care). Furthermore, glycaemic control was improved in the short term, with many participants reverting to normoglycaemia.
全球糖尿病患病率正异常上升,随之而来的是相关的医疗保健成本。本系统评价的主要结果是评估运动和饮食干预后(采用任何经过验证的量表测量)的血糖控制情况以及2型糖尿病(T2DM)诊断的发生率。次要结果评估饮食和运动干预后的体重指数变化、体重变化和身体运动能力(采用任何经过验证的量表测量)。通过检索电子数据库确定了1780项研究。相关研究经过了筛选过程。所有研究的纳入标准是通过糖耐量受损(IGT)或空腹血糖受损(IFG)诊断为糖尿病前期的人群。生活方式调整比标准治疗更能降低糖尿病发生的发生率。此外,与标准治疗相比,生活方式干预在血糖控制、身体运动能力改善和体重减轻方面表现更佳。最后,长期改善情况恶化,凸显了长期坚持生活方式改变存在的问题。总体而言,与对照组(标准护理)相比,干预组的糖尿病累积发生率大幅降低。此外,短期血糖控制得到改善,许多参与者恢复到正常血糖水平。