Wheeler M L, Delahanty L, Wylie-Rosett J
J Am Diet Assoc. 1987 Apr;87(4):480-5.
Noninsulin-dependent diabetes mellitus is a major health problem, highly correlated with obesity and, therefore, overeating. Diet continues as the cornerstone of therapy, with oral hypoglycemic agents or insulin added, if needed, to maintain normal blood glucose values. The diet prescription should be implemented in stages, with caloric restriction the first priority, as weight loss itself diminishes hyperglycemia to or toward normal. Combinations of foods and even different processing or cooking of the same food may produce different glucose responses. These factors minimize the role of the glycemic index in overall diabetes management. Foods with high soluble fiber content may diminish glucose elevations after meals; however, high-fiber foods appear to be less important for the obese diabetic person than adhering to a calorie-restricted diet and achieving weight loss. Attempts should be made to alter life-style within an acceptable degree for any given patient to encourage weight reduction. For example, although exercise may have a small but transient direct effect in lowering blood glucose and insulin resistance, it can be considered an adjunct to decreased calorie diets for weight reduction. Finally, it appears prudent to prevent or reverse obesity, especially in individuals with a family history of diabetes, in the hope that the onset of diabetes may be prevented or postponed.
非胰岛素依赖型糖尿病是一个主要的健康问题，与肥胖高度相关，因此也与暴饮暴食相关。饮食仍然是治疗的基石，如有必要，可添加口服降糖药或胰岛素以维持正常血糖值。饮食处方应分阶段实施，热量限制是首要任务，因为体重减轻本身会使高血糖症减轻或趋于正常。食物的组合，甚至同一食物的不同加工或烹饪方式，都可能产生不同的血糖反应。这些因素降低了血糖指数在糖尿病整体管理中的作用。高可溶性纤维含量的食物可能会减少餐后血糖升高；然而，对于肥胖糖尿病患者来说，高纤维食物似乎不如坚持热量限制饮食和实现体重减轻重要。应尝试在任何给定患者可接受的程度内改变生活方式，以鼓励体重减轻。例如，虽然运动可能对降低血糖和胰岛素抵抗有微小但短暂的直接作用，但它可被视为减少热量饮食以减轻体重的辅助手段。最后，预防或扭转肥胖似乎是明智的，尤其是在有糖尿病家族史的个体中，希望能预防或推迟糖尿病的发病。
