West-German Center of Diabetes and Health, Düsseldorf Catholic Hospital Group, 40591 Düsseldorf, Germany.
Department of Sports Medicine, Institute for Sports and Sport Science, University of Frankfurt, 60487 Frankfurt, Germany.
Nutrients. 2020 Jul 7;12(7):2022. doi: 10.3390/nu12072022.
Lifestyle interventions have been shown to reverse hyperglycemia to normoglycemia. However, these effects are not long-lasting and are accompanied with high dropout rates. As formula diets have been shown to be simple in usage and effective in improving glycemic control, we hypothesised that adding a low-carbohydrate and energy deficit formula diet to a low-intensity lifestyle intervention is superior in reversing prediabetes compared with lifestyle intervention alone. In this predefined subanalysis of an international, multicenter randomised controlled trial ( (ACOORH) study (ID DRKS00006811)), 141 persons with prediabetes were randomised (1:2) into either a control group with lifestyle intervention only (CON, = 45) or a lifestyle intervention group accompanied with a formula diet (INT, = 96). Both groups were equipped with telemonitoring devices. INT received a low-carbohydrate formula diet substituting three meals/day (~1200 kcal/day) within the first week, two meals/day during week 2-4, and one meal/day during week 5-26 (1300-1500 kcal/day). Follow-up was performed after 52 weeks and 105 participants (75%, INT: = 74; CON: = 31) finished the 26-week intervention phase. Follow-up data after 52 weeks were available from 93 participants (66%, INT: = 65; CON: = 28). Compared with CON, significantly more INT participants converted to normoglycemia after 52 weeks (50% vs. 31%; < 0.05). The risk reduction led to a number-needed-to-treat of 5.3 for INT. Lifestyle intervention with a low-carbohydrate formula diet reduces prediabetes prevalence stronger than lifestyle intervention alone and is effective for type 2 diabetes prevention.
生活方式干预已被证明可使高血糖恢复正常血糖水平。然而，这些效果并不持久，并且伴随着高退出率。由于配方饮食已被证明在使用上简单且在改善血糖控制方面有效，我们假设在低强度生活方式干预的基础上添加低碳水化合物和能量亏空的配方饮食在逆转前期糖尿病方面优于单独的生活方式干预。在这项国际多中心随机对照试验（ACOORH 研究（ID DRKS00006811））的预先设定的亚分析中，141 名前期糖尿病患者被随机（1:2）分为仅生活方式干预组（CON， = 45）或生活方式干预组伴配方饮食组（INT， = 96）。两组均配备远程监测设备。INT 在第一周内接受替代每日三餐（约 1200 千卡/天）的低碳水化合物配方饮食，第二周至第四周内每天接受两餐，第五周至第二十六周内每天接受一餐（1300-1500 千卡/天）。在 52 周后进行随访，105 名参与者（75%，INT： = 74；CON： = 31）完成了 26 周的干预阶段。在 52 周后，93 名参与者（66%，INT： = 65；CON： = 28）提供了随访数据。与 CON 相比，INT 组在 52 周后更多的参与者转为正常血糖水平（50%比 31%； < 0.05）。这种风险降低导致 INT 的需要治疗数为 5.3。低碳水化合物配方饮食的生活方式干预比单独的生活方式干预更能降低前期糖尿病的患病率，并且对 2 型糖尿病的预防有效。
