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非手术体重管理对复杂2型糖尿病患者体重及血糖控制的益处:一项针对12个月临床结局的初级保健服务评估

The benefits of non-surgical weight management on weight and glycaemic control in people with complex type 2 diabetes: A primary care service evaluation of clinical outcomes at 12 months.

作者信息

Avery Amanda, Griffin Jill, Stokes Julie, Coulton Rosie, Pallister Carolyn, Lavin Jacquie

机构信息

Nutrition, Health & Research team Slimming World Alfreton UK.

Audley Health Centre Stoke-on-Trent UK.

出版信息

Endocrinol Diabetes Metab. 2019 Feb 8;2(2):e00045. doi: 10.1002/edm2.45. eCollection 2019 Apr.

DOI:10.1002/edm2.45
PMID:31008360
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6458457/
Abstract

Optimizing diabetes management in patients with complex type 2 diabetes (T2DM) and obesity presents challenges. This study evaluates weight and HbA1c at 12 months (primary outcomes) and blood pressure, lipids, medication and lifestyle changes (secondary outcomes) in patients referred by a diabetes specialist (DSN) to the weight management intervention (Slimming World). Patients attended up to 12 or 24 funded weekly group sessions. The DSN recorded baseline and 12-month primary and secondary outcome data. A post-intervention questionnaire explored the lifestyle changes made. 69 patients achieved a mean weight loss of 5.5 (5.16) %, reduction in BMI [37.7(6.11) to 35.9 (6.30) kg/m,  < 0.001] and HbA1c levels [62.8 (12.85) to 55.0 (13.02) mmol/mol,  < 0.001] at 12 months. 81.2% reduced their HbA1c levels. Small reductions were observed in SBP, DBP and triglycerides, and six patients reduced their diabetes medications. Twenty patients completed the questionnaire: unhealthy snacking reduced ( < 0.001) and going for walks increased ( < 0.001) with fewer people avoiding moderate activity ( < 0.05). Despite being a chronic, progressive condition, referral to a community-based programme was successful in supporting patients with established T2DM improve their diet and activity levels, lose weight and improve their glycaemic control 12 months later with a small number able to reduce their medication.

摘要

在患有复杂2型糖尿病(T2DM)和肥胖症的患者中优化糖尿病管理面临挑战。本研究评估了由糖尿病专科护士(DSN)转介至体重管理干预项目(瘦身世界)的患者在12个月时的体重和糖化血红蛋白(主要结局),以及血压、血脂、药物治疗和生活方式的改变(次要结局)。患者参加了多达12次或24次由基金资助的每周小组课程。DSN记录了基线以及12个月时的主要和次要结局数据。一份干预后调查问卷探讨了所做出的生活方式改变。69名患者在12个月时平均体重减轻了5.5(5.16)%,体重指数降低[从37.7(6.11)降至35.9(6.30)kg/m²,P<0.001],糖化血红蛋白水平降低[从62.8(12.85)降至55.0(13.02)mmol/mol,P<0.001]。81.2%的患者糖化血红蛋白水平降低。收缩压、舒张压和甘油三酯有小幅降低,6名患者减少了糖尿病药物用量。20名患者完成了调查问卷:不健康零食的摄入量减少(P<0.001),散步次数增加(P<0.001),避免适度活动的人数减少(P<0.05)。尽管2型糖尿病是一种慢性进行性疾病,但转介至社区项目成功地支持了已确诊的T2DM患者改善饮食和活动水平,减轻体重,并在12个月后改善血糖控制,少数患者能够减少药物用量。

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