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生活方式干预在2型糖尿病预防和治疗中的作用:一项叙述性综述

The Role of Lifestyle Interventions for the Prevention and Treatment of Type 2 Diabetes: A Narrative Review.

作者信息

Espinola Octavio Pano, Tobias Deirdre K, Manson JoAnn E

机构信息

Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.

Nutrition Department, Harvard TH Chan School of Public Health, Boston, MA, USA.

出版信息

Am J Lifestyle Med. 2025 Sep 4:15598276251372427. doi: 10.1177/15598276251372427.

Abstract

The incidence of type 2 diabetes (T2D) is increasing globally alongside poor diet quality, sedentary lifestyle, and obesity, outpacing the capacity and resources to effectively prevent and manage its impact. The glycemic benefits of lifestyle modification to prevent T2D and its downstream comorbidities and mortality are supported by numerous epidemiologic studies and randomized trials. However, despite lifestyle modification being the standard of care practice both for prevention and treatment of T2D, there has been limited success in curbing this pandemic, possibly due to environmental and socioeconomic barriers to the uptake and long-term adherence to healthy lifestyle programs. Therefore, mitigating the incidence and downstream health effects of T2D requires innovative clinical and population-based solutions for the implementation of sustainable lifestyle modification interventions. It is also important for public health stakeholders to address the numerous systemic and environmental barriers that persistently undermine the long-term success of adopting healthy diet and physical activity changes. Although interventions to improve diet, physical activity, and body weight are effective for preventing T2D and many of its downstream consequences, multi-pronged efforts to enhance the uptake of these programs and support long-term adherence are critically needed to reverse the current trends of this costly and debilitating chronic disease.

摘要

随着饮食质量差、久坐不动的生活方式和肥胖问题在全球范围内日益普遍,2型糖尿病(T2D)的发病率也在不断上升,其增长速度超过了有效预防和控制其影响的能力和资源。众多流行病学研究和随机试验均证实,改变生活方式对预防T2D及其下游合并症和死亡率具有显著的血糖改善作用。然而,尽管改变生活方式是预防和治疗T2D的标准治疗方法,但在遏制这一流行病方面取得的成功有限,这可能是由于在采用和长期坚持健康生活方式计划方面存在环境和社会经济障碍。因此,减轻T2D的发病率及其对下游健康的影响需要创新的临床和基于人群的解决方案,以实施可持续的生活方式改变干预措施。公共卫生利益相关者应对持续破坏采用健康饮食和身体活动改变的长期成功的众多系统性和环境障碍也很重要。虽然改善饮食、身体活动和体重的干预措施对预防T2D及其许多下游后果有效,但迫切需要多方面努力来提高这些计划的采用率并支持长期坚持,以扭转这种代价高昂且使人衰弱的慢性病的当前趋势。

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