Korhonen T, Uusitupa M, Aro A, Kumpulainen T, Siitonen O, Voutilainen E, Pyörälä K
Department of Internal Medicine, Kuopio University Central Hospital, Finland.
Acta Med Scand. 1987;222(4):323-31. doi: 10.1111/j.0954-6820.1987.tb10679.x.
Eighty consecutive newly diagnosed non-insulin-dependent diabetic patients were randomly allocated into two groups to compare two different patient education regimens. One group received individual dietary instructions by a nurse and the other a short, written leaflet given by a doctor. The principal aim of the dietary instructions was weight reduction. A significant weight loss and improvement in the control of diabetes occurred in both groups, and these changes were similar in the two groups. At the end of one year's follow-up, however, only 25% of the patients were satisfactorily controlled (fasting blood glucose less than or equal to 6.0 mmol/l). The degree of weight loss correlated only weakly with the improvement in the metabolic control. The degree of obesity and insulin secretion capacity as measured at the beginning of the study did not predict the improvement of glycaemic control during the study. At the end of the study a significant improvement was observed in serum lipids of patients with good control (fasting blood glucose less than or equal to 6.0 mmol/l) or weight loss (greater than 5 kg). In conclusion, both brief, written and individual dietary instructions induced a significant weight loss as well as improved glucose and lipid metabolism in newly diagnosed non-insulin-dependent diabetic patients, but satisfactory metabolic control was achieved only in a minority of the patients.
80名连续新诊断的非胰岛素依赖型糖尿病患者被随机分为两组，以比较两种不同的患者教育方案。一组由护士给予个性化饮食指导，另一组由医生提供简短的书面传单。饮食指导的主要目的是减轻体重。两组患者均出现显著的体重减轻和糖尿病控制改善，且两组的这些变化相似。然而，在一年的随访结束时，只有25%的患者得到了满意的控制（空腹血糖小于或等于6.0 mmol/L）。体重减轻程度与代谢控制改善之间的相关性较弱。研究开始时测量的肥胖程度和胰岛素分泌能力并不能预测研究期间血糖控制的改善情况。在研究结束时，血糖控制良好（空腹血糖小于或等于6.0 mmol/L）或体重减轻（大于5 kg）的患者血清脂质有显著改善。总之，简短的书面和个性化饮食指导均能使新诊断的非胰岛素依赖型糖尿病患者显著减轻体重，并改善糖脂代谢，但只有少数患者实现了满意的代谢控制。
