研究表明:僅通過減肥就能緩解糖尿病

You could cure your Type 2 ?diabetes if you follow new ?advice from your GP. Around four million UK patients with the condition might be helped - they could go into remission and even come off drugs.

如果你遵循全科醫(yī)生的新建議，那2型糖尿病是可以治愈的。大約400萬名英國患者或從中受益--或許可以減少吃藥量，甚至不吃藥。

A wonderful study, The Diabetes Remission Clinical Trial (DiRECT), has shown that weight management supervised by GPs might normalise blood sugar levels without the use of drugs. This is a complete change in the treatment of diabetes. "It's a crashingly simple disease," says one of the trial's researchers, Roy Taylor, professor of medicine and metabolism at Newcastle University.

糖尿病緩解臨床試驗(yàn)(DiRECT)這項(xiàng)精彩研究表明：全科醫(yī)生對你的體重管理進(jìn)行監(jiān)督可能讓你在不服藥的情況下使你的血糖水平恢復(fù)正常。這徹底顛覆了糖尿病治療。"這只是一種非常簡單的疾病，"試驗(yàn)的一名研究員羅伊·泰勒說道，他是紐卡斯?fàn)柎髮W(xué)醫(yī)學(xué)與代謝學(xué)教授。

The DiRECT study "shows conclusively that Type 2 diabetes is caused by chronic calorie excess," he says. This triggers "a twin cycle of deterioration" - first, fat accumulates in the liver and eventually spills over into the pancreas. This results in failure of insulin secretion after eating, and precipitates the onset of hyperglycaemia (high blood sugar).

The DiRECT研究"明確表明，2型糖尿病是由慢性卡路里過量引起的，"他說道。這會導(dǎo)致"雙相惡化循環(huán)"--首先，脂肪堆積在肝臟，最終溢出至胰腺。進(jìn)而導(dǎo)致進(jìn)食后不能分泌胰島素，引發(fā)高血糖。

Prof Taylor adds: "Losing less than 1g of fat from the pancreas can restart the normal production of insulin, reversing Type 2 diabetes. That can only be done through substantial weight loss rather than by any drug." If a new drug showed similar results we'd be over the moon.

泰勒教授補(bǔ)充道："減少不到一克的胰腺脂肪就能重新開始正常分泌胰島素，緩解2型糖尿病。這只能通過大幅度減重實(shí)現(xiàn)，靠藥物是行不通的。"如果新藥品能展現(xiàn)相似的結(jié)果，我們會樂開花的。

Stephen Lawrence, clinical lead for diabetes at the Royal College of General Practitioners and fellow at Warwick University, heralded the DiRECT paper as a "landmark study". DiRECT, the biggest ever study funded by the charity Diabetes UK, tracked 298 patients who'd had diabetes diagnosed during the previous six years.

皇家全科醫(yī)師學(xué)院的臨床主管、華威大學(xué)的研究員史蒂芬·勞倫斯認(rèn)為DiRECT研究是一項(xiàng)"具有里程碑意義的研究"。DiRECT是由英國糖尿病慈善機(jī)構(gòu)資助的有史以來規(guī)模最大的研究，跟蹤了298名連續(xù)6年都被診斷出患有糖尿病的患者。

Half were assigned to take diabetes drugs and receive conventional weight-loss advice. The other half were told to stop taking all drugs for diabetes and to eat a low-calorie diet balanced in nutrients - shakes or soups containing no more than 853 calories a day - for up to five months.

一半的患者被要求服用治療糖尿病的藥物、接受常規(guī)的減肥建議。另一半被告知停止服用一切治療糖尿病的藥物、吃低卡、營養(yǎng)均衡的飲食--奶昔或湯，持續(xù)5個(gè)月每天不超過853卡。

They were then given intensive guidance by their GPs to gradually reintroduce a normal diet, individually tailored, over two to eight weeks. Michael Lean, co-lead of DiRECT, points out: "In DiRECT, 40% of the patients were from the two most deprived socioeconomic groups, and 40% were being treated with six or more drugs for a variety of diseases." There's no doubt this made it a stiff test of the treatment.

之后，他們的全科醫(yī)生會給他們進(jìn)行強(qiáng)化指導(dǎo)，在2至8周的時(shí)間里，慢慢的讓他們開始正常飲食(根據(jù)個(gè)人量身定制)。DiRECT的聯(lián)合負(fù)責(zé)人Michael Lean指出："在DiRECT中，40%的患者來自兩個(gè)最貧困的社會經(jīng)濟(jì)群體，40%的患者服用6種或以上的藥物治療各種疾病。"毫無疑問，這是對治療的嚴(yán)峻考驗(yàn)。