Melander A
NEPI Foundation, Medical Research Centre, Malmö University Hospital, Sweden.
Diabet Med. 1996;13(3 Suppl 2):S20-2.
Long-term intervention studies have evaluated the effect of diet, exercise and pharmacological regimens on the conversion rate of impaired glucose tolerance (IGT) to non-insulin dependent diabetes mellitus (NIDDM). Two UK studies, the Bedford study (10 years) and the Whitehall study (5 years), found that a diet which restricts carbohydrate intake to less than 120 g/day had no effect on the development of NIDDM in subjects with IGT. In contrast, the Swedish Malmöhus study (10 years) found that the conversion rate was reduced from 29% in the control group to 13% in a group told to limit their intake of carbohydrates and lipids and to reduce weight when overweight. A further Swedish study, the Malmö study (6 years and ongoing) is investigating a combination of dietary intervention and a strenuous exercise programme. In this study the conversion rate decreased from 29% in the control group to 11% in the diet plus exercise group. The Bedford and Whitehall studies also investigated intervention with tolbutamide and phenformin, respectively. Neither drug was found to have an effect on the conversion rate in either study. In contrast, positive results for tolbutamide were obtained in the Malmöhus study. No subjects in the tolbutamide plus diet group developed NIDDM compared with 29% in the control group. This regimen was also found to have beneficial effects on blood pressure, serum lipids and on cardiovascular morbidity and mortality.
长期干预研究评估了饮食、运动和药物治疗方案对糖耐量受损（IGT）向非胰岛素依赖型糖尿病（NIDDM）转化率的影响。两项英国研究，即贝德福德研究（10年）和白厅研究（5年）发现，将碳水化合物摄入量限制在每日120克以下的饮食对IGT患者发生NIDDM没有影响。相比之下，瑞典马尔默胡斯研究（10年）发现，在被告知限制碳水化合物和脂质摄入并在超重时减重的一组中，转化率从对照组的29%降至13%。另一项瑞典研究，即马尔默研究（为期6年且仍在进行）正在研究饮食干预与剧烈运动计划的联合作用。在这项研究中，转化率从对照组的29%降至饮食加运动组的11%。贝德福德研究和白厅研究还分别研究了甲苯磺丁脲和苯乙双胍的干预效果。两项研究均未发现这两种药物对转化率有影响。相比之下，马尔默胡斯研究中甲苯磺丁脲取得了阳性结果。甲苯磺丁脲加饮食组中没有受试者发生NIDDM，而对照组为29%。该治疗方案还被发现对血压、血脂以及心血管发病率和死亡率有有益影响。
