Pissarek D, Panzram G, Lundershausen R, Adolph W, Senf L
Endokrinologie. 1980 Jan;75(1):105-15.
In a prospective study 150 newly detected maturity onset-diabetics were randomized in 2 biostatistically comparable groups and underwent a treatment of different intensity. While the patients of the control group were treated according to the routine method used up to now in the dispensary for diabetics, in the intervention group an intensifying of the therapy took place, taking particular into consideration the body weight as well as the carbohydrate and fat metabolism. The decrease of body weight achieved by dietary intensive care proved to be the decisive factor for the tendency towards normalisation of glucose tolerance, hyperlipoproteinaemia and IRI-secretion, which could be registered in the intervention group after 2 years of observation. Following the preceding strong phase of diet, by Biguanides and Clofibrate a further significant improvement of the carbohydrate and fat metabolism could not be achieved. The decisive reserve in the treatment of obese maturity onset-diabetes could be seen in a permanent and continuous reduction of body weight. The results of this treatment depend highly on an intensive education as well as on frequent control of the patients' metabolism and their cooperation.
在一项前瞻性研究中,150名新确诊的成年发病型糖尿病患者被随机分为两个生物统计学上可比的组,并接受了不同强度的治疗。对照组患者按照目前糖尿病门诊一直使用的常规方法进行治疗,而干预组则加强了治疗,特别考虑了体重以及碳水化合物和脂肪代谢。通过饮食强化护理实现的体重减轻被证明是干预组在观察2年后糖耐量、高脂蛋白血症和胰岛素释放指数分泌趋于正常化趋势的决定性因素。在经历了之前严格的饮食阶段后,使用双胍类药物和氯贝丁酯无法进一步显著改善碳水化合物和脂肪代谢。肥胖成年发病型糖尿病治疗的决定性储备在于体重的持续和不断减轻。这种治疗的效果高度依赖于强化教育以及对患者代谢情况的频繁监测和他们的配合。