Magnetic Resonance Centre, Institute of Cellular Medicine and Human Nutrition Research Centre, University of Newcastle upon Tyne, UK.
Institute of Health and Society, University of Newcastle upon Tyne, UK.
Diabet Med. 2019 Mar;36(3):308-315. doi: 10.1111/dme.13851. Epub 2018 Dec 3.
The James Lind Alliance, in association with Diabetes UK, conducted a survey of people with Type 2 diabetes to establish their priorities for research. The number one research priority was found to be 'Can Type 2 diabetes be cured or reversed, what is the best way to achieve this, and is there a point beyond which the condition cannot be reversed?'. The present review summarizes the current understanding of weight loss-induced reversal of Type 2 diabetes. It considers the diagnostic criteria for remission and describes the clinical features of post-diabetes. It is of great importance to recognize these, as post-diabetes differs considerably from the high cardiovascular risk state of prediabetes. Current data demonstrate long-term stable β-cell function, providing weight regain is prevented. If an individual, having previously demonstrated susceptibility to Type 2 diabetes, returns to their previous weight then recurrence of the condition is certain. Appropriate use of the terms 'reversal' and 'remission' is discussed, with emphasis that the word 'cure' is inappropriate. Evidence-based means of achieving and maintaining remission of Type 2 diabetes are described, together with a summary of the information on the steadily diminishing chance of achieving reversal with increasing duration of Type 2 diabetes.
詹姆斯林德联盟（James Lind Alliance）与英国糖尿病协会（Diabetes UK）合作，对 2 型糖尿病患者进行了一项调查，以确定他们对研究的优先事项。结果发现，首要的研究重点是“2 型糖尿病能否治愈或逆转，实现这一目标的最佳方法是什么，以及是否存在无法逆转的临界点？”。本综述总结了目前对体重减轻引起的 2 型糖尿病逆转的理解。它考虑了缓解的诊断标准，并描述了糖尿病后的临床特征。重要的是要认识到这一点，因为糖尿病后与 prediabetes 的高心血管风险状态有很大的不同。目前的数据表明，长期稳定的β细胞功能，只要防止体重增加。如果一个曾经表现出易患 2 型糖尿病的个体恢复到以前的体重，那么该疾病肯定会再次发作。本文讨论了“逆转”和“缓解”这两个术语的恰当使用，并强调“治愈”这个词不恰当。描述了实现和维持 2 型糖尿病缓解的循证方法，并总结了随着 2 型糖尿病持续时间的增加，实现逆转的机会稳步减少的信息。
