Ko Jung Hae, Kim Tae Nyun
Division of Endocrinology and Metabolism, Department of Internal Medicine, Inje University College of Medicine, Busan, Korea.
J Obes Metab Syndr. 2022 Jun 30;31(2):123-133. doi: 10.7570/jomes22001. Epub 2022 May 27.
Type 2 diabetes (T2D) has long been regarded as an incurable and chronic disease according to conventional management methods. Clinical and pathophysiological studies on the natural course of T2D have shown that blood glucose control worsens with an increase in the number of required anti-hyperglycemic agents, as β-cell function progressively declines over time. However, recent studies have shown remission of T2D after metabolic surgery, intensive lifestyle modification, or medications, raising the possibility that β-cell function may be preserved or the decline in β-cell function may even be reversible. The World Health Organization as well as the American Diabetes Association and the European Association for the Study of Diabetes recognize remission as an appropriate management aim. In the light of the state of evidence for T2D reversal, physicians need to be educated on treatment options to achieve T2D remission so that they can actively play a part in counseling patients who may wish to explore these approaches to their disease. This review will introduce each of these approaches, summarizing their beneficial effects, supporting evidence, degree of sustainability, and challenges to be addressed in the future.
根据传统管理方法，2型糖尿病（T2D）长期以来一直被视为一种无法治愈的慢性疾病。关于T2D自然病程的临床和病理生理学研究表明，随着所需降糖药物数量的增加，血糖控制会恶化，因为β细胞功能会随着时间的推移而逐渐下降。然而，最近的研究表明，代谢手术、强化生活方式改变或药物治疗后T2D可缓解，这增加了β细胞功能可能得到保留或β细胞功能下降甚至可能可逆的可能性。世界卫生组织以及美国糖尿病协会和欧洲糖尿病研究协会都认可缓解是一种合适的管理目标。鉴于T2D逆转的证据状况，需要对医生进行关于实现T2D缓解的治疗选择的教育，以便他们能够积极参与为可能希望探索这些疾病治疗方法的患者提供咨询。本综述将介绍每种方法，总结其有益效果、支持证据、可持续程度以及未来需要解决的挑战。
