INFLUENCES ON WEIGHT-LOSS IN TYPE-2 DIABETIC-PATIENTS - LITTLE LONG-TERM BENEFIT FROM GROUP-BEHAVIOR THERAPY AND EXERCISE TRAINING

被引：36

作者：

BLONK, MC ^{[1
]}

JACOBS, MAJM ^{[1
]}

BIESHEUVEL, EHE ^{[1
]}

WEEDAMANNAK, WL ^{[1
]}

HEINE, RJ ^{[1
]}

机构：

[1] FREE UNIV AMSTERDAM HOSP,DEPT INTERNAL MED,DE BOELELAAN 1117,1081 HV AMSTERDAM,NETHERLANDS

来源：

DIABETIC MEDICINE | 1994年 / 11卷 / 05期

关键词：

WEIGHT REDUCTION PROGRAM; DIABETES; GLYCEMIC CONTROL; BLOOD PRESSURE; LIPIDS;

D O I：

10.1111/j.1464-5491.1994.tb00305.x

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The aim of our study was to assess the long-term (24 months) efficacy of a comprehensive weight reduction programme as compared to that of a conventional programme. The Comprehensive Programme comprised, besides the Conventional Programme (diet counselling), behavioural modification and exercise training. The 2-year follow-up period was completed by 53 patients (19M/34F; 88.3 %). The differences (95 % confidence intervals; CI) between the change in body weight of patients in the Comprehensive Programme compared to the Conventional Programme after 6 and 24 months of treatment were -2.2 (-4.0, -0.3) kg, p = 0.03 and -1.3 (-3.3, 0.7) kg, p = 0.21, respectively. In comparison to the Conventional Programme, the Comprehensive Programme resulted in a greater decrease (95 % CI) of HbA1c after 6 months: -0.8 (-1.2, -0.2) %, p = 0.01, but not after 2 years: -0.4 (-1.0, 0.1) %, p = 0.12. The effects on blood pressure and serum lipids of the Comprehensive Programme and the Conventional Programme were comparable. Changes in body weight at 6 months correlated well with changes in HbA1c, fasting plasma insulin, and blood pressure, whereas at 24 months no.such correlation was found with HbA1c. Pretreatment variates that were associated with the greatest 2-year weight loss were a high HbA1c value, a low energy per cent carbohydrate intake and a low percentage of obese subjects within the family. In conclusion, the long-term outcome of the Comprehensive Programme was not different from that of the Conventional Programme. The achieved body weight reduction was associated with a sustained fall in blood pressure, but with only a transient beneficial effect on the glycaemic control in the Type 2 diabetic patient.

引用

页码：449 / 457

页数：9

共 44 条

[21] Fitzwater SL, Weinsier RL, Wooldridge NH, Birch R., Liu, Bartolucci AA, Evaluation of long‐term weight changes after a multidisciplinary weight control program, J Am Diet Assoc, 91, pp. 421-426, (1991)
[22] Wing RR, Epstein LH, Paternostro-Bayles M., Kriska A., Nowalk MP, Gooding W., Exercise in a behavioural weight control programme for obese patients with type 2 (non‐insulin‐dependent) diabetes, Diabetologia, 31, pp. 902-909, (1988)
[23] Watts NB, Spanheimer RG, DiGirolamo M., Gebhart SSP, Musey VC, Siddiq, Phillips LS, Prediction of glucose response to weight loss in patients with non‐insulin‐dependent diabetes mellitus, Arch Intern Med, 150, pp. 803-806, (1990)
[24] Second Report on Diabetes Mellitus, (1980)
[25] Lukaski HC, Methods for the assessment of human body composition: traditional and new, Am J Clin Nutr, 46, pp. 537-556, (1987)
[26] Blonk MC, de Vries PMJM, Heine RJ, Bioelectrical impedance analysis and skinfold thickness to assess the fat distribution of normal and obese volunteers (Abstract), Int J Obesity, 13, (1989)
[27] Terpstra AHM, Woodward, Sanchez-Muniz FJ, Improved techniques for the separation of serum lipoproteins by density gradient ultracentrifugation: visualization by prestaining and rapid separation of serum lipoproteins from small volumes of serum, Anal Biochem, 111, pp. 149-157, (1981)
[28] Lehman EL, Nonparametrics, Statistical methods based on ranks, pp. 81-95, (1975)
[29] West KM, Diet therapy of diabetes: an analysis of failure, Ann Intern Med, 79, pp. 425-434, (1973)
[30] Perri MG, Sears SF, Clark JE, Strategies for improving maintenance of weight loss. Toward a continuous care model of obesity management, Diabetes Care, 16, pp. 200-209, (1993)

← 1 2 3 4 5 →