强化生活方式干预早期2型糖尿病患者的疗效分析

An analysis of efficacy of intensive lifestyle intervention in patients with type 2 diabetes mellitus in early stage

目的观察强化生活方式干预对早期2型糖尿病(T2DM)患者的体重、血糖水平和主要心血管代谢指标的影响。方法早期T2DM患者138例,随机均分为两组:对照组采用常规糖尿病治疗;干预组在对照组基础上加用强化生活方式干预,包括饮食营养教育、指导体育活动、督促按时用药以及采用当下通联设备与患者形成及时良性沟通等。随访12个月,分析两组BMI、腰围(WC)、SBP、DBP、FBG、餐后2-h血糖(2hPBG)、HbA1c、FIns、空腹C肽(FC-P)、TC、TG、LDL-C、HDL-C和HOMA-IR的变化及其组间差异。结果12个月随访结果显示,干预组BMI、WC、SBP、FBG、2hPBG、HbA1c、TC、TG、LDL-C和HOMA-IR水平均较治疗前下降,并低于对照组(P<0.05);FIns和FC-P水平较治疗前上升,并高于对照组(P<0.05)。结论在常规糖尿病治疗基础上,实施强化生活方式干预可以更好地控制早期T2DM患者的体重和血糖水平,改善相关代谢指标。

Objective To observe the effects of intensive lifestyle intervention on body weight,main cardiovascular metabolic index and blood glucose level in the patients with type 2 diabetes mellitus(T2 DM)in early stage.Methods A total of 138 patients with T2 DM in early stage was randomly divided into two groups and treated with conventional treatment for T2 DM(group C,69 cases)or combined use of conventional treatment and intensive lifestyle intervention(group A,69 cases).The intensive lifestyle intervention included the education of diet and nutrition,instruction of physical activities,and therapeutic drug taking and establishment of benign communication with the patients timely by current communication equipments.The patients were followed up for 12 months.The changes and differences between the two groups in the body mass index(BMI),waist circumference(WC),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FBG),2-hour postprandial blood glucose(2 hPBG),glycosylated hemoglobin A1 c(HbA1 c),fasting insulin(FIns),fasting C-peptide(FC-P),total cholesterol(TC),triacylglycerol(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein(LDL-C)and homeostasis model assessment of insulin resistance(HOMA-IR)were analyzed.Results Compared to before,BMI,WC,SBP,FBG,2 hPBG,HbA1 c,TC,TG,LDL-C and HOMA-IR in group A were significantly decreased 12 months after treatment,which were significantly lower than those in group C(P<0.05).Compared to before,FIns and FC-P in group A were significantly increased 12 months after treatment,which were significantly higher than those in group C(P<0.05).Conclusion On the basis of conventional diabetes treatment,additionally use of intensive lifestyle intervention can better control the body weight and blood glucose level and improve relevant metabolic indexes in the patients with T2 DM in early stage.