饮食、运动和生活方式变更在肥胖型糖尿病患者治疗中的作用

The challenge of diet,exercise and lifestyle modification in the management of the obese diabetic patient

2型糖尿病（ 2－ DM）与肥胖、肾病、微血管病和动脉粥样硬化有关。因为该病的并发症及慢性化，所以通过改变生活方式而降低饮食、起居方面的危险因素，对 2－ DM患者长期健康是极为重要的。患者要学会、低脂的饮食习惯和正规的运动模式。本文要介绍针对肥胖的糖尿病患者生活方式的改良。还将讨论一些关于改变生活方式和提高长期随访率的困难。最后，我们要介绍 2－ DM高危人群 ,在美国的墨西哥人是怎样实施这些方案的。

Type 2 diabetes is associated with many comorbic medical conditions including obesity,neuropathy,microvascular pathology and athersclerotic arterial disease.Due to its complications and chronicity,reducing rick factors such as obesity and sedentary lifestyle through lifestyle modification is crucial to the long－ term health of patients with type 2 diabetes.Patients must learn how to adopt lifeong,low－ fat eating habits and regular activety patterns,with formal treatments focusing on weight loss,increased physical activity and low－ fat,low－ saturated fat diets.In this article we review the efficacy of lifestyle modification programmes for obese diabetic patients.In addition,we discuss barriers to lifestyle changes and methods for improving long－ term adherence.Finally,we present information on how this approach has been adapted to a group of Mexican Americans in the USA,a population at high risk for type 2 diabetes,obesity and sedentary lifestyle.