英国纽卡斯尔和格拉斯哥大学的研究表明，低热量饮食可以逆转2型糖尿病

Radical diet can reverse type 2 diabetes, new study shows

 

研究人员说，低热量饮食可以逆转90%的糖尿病患者，甚至包括那些已经有6年糖尿病的患者，他们体重减少15公斤或更多。

　

 

一项新的研究发现，低卡路里饮食可以逆转2型糖尿病，甚至患病已经6年的患者。

 

与肥胖症流行有关的2型糖尿病病例正在激增。腹部积累的脂肪阻碍了胰腺的正常功能。它会导致严重的、危及生命的并发症，包括失明、截肢、心脏病和肾病。

 

纽卡斯尔和格拉斯哥大学的一项新研究表明，这种疾病可以通过减轻体重来逆转，这样患者就不必再服用药物，也就不会出现症状和风险。在这项试验中，每10个减重15公斤(2.5英石)或以上的人中就有9个能缓解他们的2型糖尿病。

 

　

　

来自纽卡斯尔大学的罗伊·泰勒教授是这项由英国糖尿病资助的试验的首席研究员，他说:“这些发现非常令人兴奋。他们可以彻底改变2型糖尿病的治疗方式。这是建立在疾病原因的研究基础上，使我们能够有效地进行管理。

 

“大量的减肥导致肝脏和胰腺内的脂肪减少，使这些器官恢复正常功能。”我们所看到的是，减肥不仅仅与更好地控制2型糖尿病有关:显著的减肥实际上可以带来持久的缓解。

 

在全球范围内，2型糖尿病患者的数量在35年间翻了两番，从1980年的1.08亿增至2014年的4.22亿。预计到2040年，这一数字将攀升至6.42亿。在英国，每10个成年人就有一个患糖尿病，每年公共卫生系统在在糖尿病患者的指出高达140亿英镑。

 

2型糖尿病通常通过药物治疗，在某些情况下，通过减肥手术来限制胃容量，这也被证明可以逆转疾病。

 

2型糖尿病的管理指导方针没有解决根本原因，而是侧重于通过药物治疗降低血糖水平。饮食和生活方式经常被触及，但是通过减少卡路里来缓解糖尿病很少被讨论。

 

“与其他研究的一个主要区别是，我们建议一段时间的饮食减肥，但不增加体力活动，但在长期的随访中，日常活动的增加是很重要的。”减肥手术能使四分之三的人减轻糖尿病，但它更昂贵，风险更大，而且只有少数病人能接受。

 

该试验结果发表在《柳叶刀》杂志上，并在阿布扎比举行的国际糖尿病联合会大会上公布。

 

结果显示，一年后，参与者平均减掉了10公斤，近一半的人回复到非糖尿病状态。

 

在这项试验中，有298名年龄在20岁至65岁之间的成年人参与了试验，他们在过去六年中被诊断为2型糖尿病，来自苏格兰和泰恩赛德的49个初级护理机构。其中一半的做法是让病人吃低热量的食物，而剩下的是对照组，病人接受常规治疗。控制组中只有4%的人成功缓解了疼痛。

　

　

在3到5个月的时间里，每天摄入的热量为825-853卡路里，然后在两到八周内逐步重新摄入食物。参与者都得到了支持，包括认知行为治疗和鼓励锻炼。

 

 “我们的研究结果表明，即使你已经患有2型糖尿病达6年之久，缓解这种疾病也是可行的，”参与这项研究的格拉斯哥大学的Michael Lean教授说。“与其他方法相比，我们关注的是通过饮食和锻炼长期维持体重的需要，并鼓励灵活地优化个体结果。”

 

来自北艾尔郡的65岁的伊泽贝尔·默里就是其中之一。两年多的时间里，她减掉了3.5英石(22公斤)，不再需要药物治疗。“它改变了我的生活，”她说。“在研究之前，我有2 - 3年的2型糖尿病。我服用了各种各样的药物，这些药物不断增加，我的病一天比一天严重。

 

“当医生告诉我，我的胰腺再次恢复正常工作时，感觉棒极了，简直棒极了。”我不再认为自己是糖尿病患者了"

 

泰勒说，这一研究结果表明，减肥手术所能带来的巨大减肥效果，并不是逆转疾病的必要条件。这项计划提供的减肥目标对很多人来说都是可以实现的。最大的挑战是长期避免体重再增加，”他说。

　

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Radical diet can reverse type 2 diabetes, new study shows

Low-calorie diet caused remission in 90% of trial patients who lost 15kg or more, even those who had been diabetic for six years, say researchers

 

A radical low-calorie diet can reverse type 2 diabetes, even six years into the disease, a new study has found.

 

The number of cases of type 2 diabetes is soaring, related to the obesity epidemic. Fat accumulated in the abdomen prevents the proper function of the pancreas. It can lead to serious and life-threatening complications, including blindness and foot amputations, heart and kidney disease.

 

A new study from Newcastle and Glasgow Universities shows that the disease can be reversed by losing weight, so that sufferers no longer have to take medication and are free of the symptoms and risks. Nine out of 10 people in the trial who lost 15kg (two-and-a-half stone) or more put their type 2 diabetes into remission.

 

 

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Prof Roy Taylor from Newcastle University, lead researcher in the trial funded by Diabetes UK, said: “These findings are very exciting. They could revolutionise the way type 2 diabetes is treated. This builds on the work into the underlying cause of the condition, so that we can target management effectively.

 

“Substantial weight loss results in reduced fat inside the liver and pancreas, allowing these organs to return to normal function. What we’re seeing … is that losing weight isn’t just linked to better management of type 2 diabetes: significant weight loss could actually result in lasting remission.”

 

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Worldwide, the number of people with type 2 diabetes has quadrupled over 35 years, rising from 108 million in 1980 to 422 million in 2014. This is expected to climb to 642 million by 2040. Type 2 diabetes affects almost 1 in 10 adults in the UK and costs the NHS about £14bn a year.

 

Type 2 diabetes is usually treated with medication and in some cases, bariatric surgery to restrict stomach capacity, which has also been shown to reverse the disease.

 

“Rather than addressing the root cause, management guidelines for type 2 diabetes focus on reducing blood sugar levels through drug treatments. Diet and lifestyle are touched upon, but diabetes remission by cutting calories is rarely discussed,” said Taylor.

 

“A major difference from other studies is that we advised a period of dietary weight loss with no increase in physical activity, but during the long-term follow up increased daily activity is important. Bariatric surgery can achieve remission of diabetes in about three-quarters of people, but it is more expensive and risky, and is only available to a small number of patients.”

 

The trial results, published in the Lancet and presented at the International Diabetes Federation Congress in Abu Dhabi, show that after one year, participants had lost an average of 10kg, and nearly half had reverted to a non-diabetic state.

 

There were 298 adults on the trial aged 20–65, who had been diagnosed with type 2 diabetes within the last six years, from 49 primary care practices in Scotland and Tyneside. Half of the practices put their patients on the very low calorie diet, while the rest were a control group, in which patients received usual care. Only 4% of the control group managed to achieve remission.

 

The diet was a formula of 825–853 calories per day for 3 to 5 months, followed by the stepped reintroduction of food over two to eight weeks. The participants were all given support throughout, including cognitive behaviour therapy and were encouraged to exercise.

 

 

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“Our findings suggest that even if you have had type 2 diabetes for six years, putting the disease into remission is feasible”, says Prof Michael Lean from the University of Glasgow who co-led the study. “In contrast to other approaches, we focus on the need for long-term maintenance of weight loss through diet and exercise and encourage flexibility to optimise individual results.”

 

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Isobel Murray, 65 from North Ayrshire, was one of those who took part. Over two years she lost three and a half stone (22kg) and no longer needs medication. “It has transformed my life,” she said. “I had type 2 diabetes for two to three years before the study. I was on various medications which were constantly increasing and I was becoming more and more ill every day.

 

“When the doctors told me that my pancreas was working again, it felt fantastic, absolutely amazing. I don’t think of myself as a diabetic anymore.”

 

Taylor said that the trail shows that the very large weight losses that bariatric surgery can bring about are not necessary to reverse the disease. “The weight loss goals provided by this programme are achievable for many people. The big challenge is long-term avoidance of weight re-gain,” he said.

　

Radical diet can reverse type 2 diabetes, new study shows | Society | The Guardian  https://www.theguardian.com/society/2017/dec/05/radical-diet-can-reverse-type-2-diabetes-new-study-shows