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具有减肥作用的降糖药物联合高蛋白饮食及适度运动对肥胖型2型糖尿病成人患者糖尿病缓解的影响:一项随机对照试验

Effect of hypoglycemic agents with weight loss effect plus a high protein diet and moderate exercise on diabetes remission in adults with obesity and type 2 diabetes: a randomized controlled trial.

作者信息

Zhang Shi, Wang Yi, Wang Xincheng, Leng Mingxin, Liu Renjiao, Li Zhouhuiling, Li Jing, Xiao Jixuan, Hou Dangmin, Gao Xinying, Li Chunjun

机构信息

Department of Health Management Center, Endocrinology, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, Tianjin, China.

出版信息

BMC Med. 2025 May 7;23(1):270. doi: 10.1186/s12916-025-04072-4.

Abstract

BACKGROUND

This study aimed to explore the effects of hypoglycemic agents with weight loss effect plus a high protein diet and moderate exercise on weight loss and diabetes remission in adults with obesity and newly diagnosed prediabetes/type 2 diabetes (T2D).

METHODS

Participants with obesity and newly diagnosed prediabetes or T2D (n = 61) were randomly allocated to standard treatment group (conventional medication and lifestyle guidance for 12 months) and intensive treatment group (in addition to conventional medication, a high protein diet and moderate exercise were given for 12 months).

RESULTS

By month 12, 60 (98.4%) participants completed the 12-month follow-up visit. In the intensive treatment group, 73.33% patients in the prediabetes subgroup returned to normoglycemia and the diabetes remission rate was 86.67% in the diabetes subgroup, which were much higher than the remission rate of prediabetes subgroup (7.69%) and diabetes subgroup (16.67%) in the standard treatment group (P < 0.001). The mean weight change was - 19.29 kg (95% CI, - 22.95 to - 15.63) in the intensive treatment group and - 1.52 kg (95% CI, - 5.12 to 2.07) in the standard treatment group from baseline after intervention. The weight change between the two groups was significantly different (net difference, - 17.77 kg; 95% CI, - 22.90 to - 12.64; P < 0.001). Percent of body fat, visceral fat area, and hepatic controlled attenuation parameter value reduced significantly in the intensive treatment group compared to the standard treatment group (P < 0.001).

CONCLUSIONS

Hypoglycemic agents with weight loss effect plus a high protein diet and moderate exercise could lead to a considerable proportion of patients with diabetes achieving diabetes remission.

TRIAL REGISTRATION

chictr.org.cn ChiCTR2100044305.

摘要

背景

本研究旨在探讨具有减肥作用的降糖药物联合高蛋白饮食及适度运动对肥胖且新诊断为糖尿病前期/2型糖尿病(T2D)的成年人减肥及糖尿病缓解的影响。

方法

将肥胖且新诊断为糖尿病前期或T2D的参与者(n = 61)随机分配至标准治疗组(接受12个月的常规药物治疗及生活方式指导)和强化治疗组(除常规药物治疗外,给予12个月的高蛋白饮食及适度运动)。

结果

到第12个月时,60名(98.4%)参与者完成了12个月的随访。在强化治疗组中,糖尿病前期亚组73.33%的患者血糖恢复正常,糖尿病亚组的糖尿病缓解率为86.67%,远高于标准治疗组糖尿病前期亚组(7.69%)和糖尿病亚组(16.67%)的缓解率(P < 0.001)。干预后,强化治疗组的平均体重变化为-19.29 kg(95%CI,-22.95至-15.63),标准治疗组为-1.52 kg(95%CI,-5.12至2.07)。两组间体重变化有显著差异(净差异,-17.77 kg;95%CI,-22.90至-12.64;P < 0.001)。与标准治疗组相比,强化治疗组的体脂百分比、内脏脂肪面积和肝脏控制衰减参数值显著降低(P < 0.001)。

结论

具有减肥作用的降糖药物联合高蛋白饮食及适度运动可使相当比例的糖尿病患者实现糖尿病缓解。

试验注册

chictr.org.cn ChiCTR2100044305。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81ad/12060396/758af6c0654b/12916_2025_4072_Fig1_HTML.jpg

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