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.
如果你遵循全科医生的新建议,那2型糖尿病是可以治愈的。大约400万名英国患者或从中受益--或许可以减少吃药量,甚至不吃药。
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.
糖尿病缓解临床试验(DiRECT)这项精彩研究表明:全科医生对你的体重管理进行监督可能让你在不服药的情况下使你的血糖水平恢复正常。这彻底颠覆了糖尿病治疗。"这只是一种非常简单的疾病,"试验的一名研究员罗伊·泰勒说道,他是纽卡斯尔大学医学与代谢学教授。
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"明确表明,2型糖尿病是由慢性卡路里过量引起的,"他说道。这会导致"双相恶化循环"--首先,脂肪堆积在肝脏,最终溢出至胰腺。进而导致进食后不能分泌胰岛素,引发高血糖。
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.
泰勒教授补充道:"减少不到一克的胰腺脂肪就能重新开始正常分泌胰岛素,缓解2型糖尿病。这只能通过大幅度减重实现,靠药物是行不通的。"如果新药品能展现相似的结果,我们会乐开花的。
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.
皇家全科医师学院的临床主管、华威大学的研究员史蒂芬·劳伦斯认为DiRECT研究是一项"具有里程碑意义的研究。"DiRECT,由英国糖尿病慈善机构资助的有史以来规模最大的研究,跟踪了298名患者,他们在此前的6年都被诊断出患有糖尿病。
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疗糖尿病的药物、接受常规的减肥建议。另一半被告知停止服用一切治疗糖尿病的药物、吃低卡、营养均衡的饮食--奶昔或汤,每天不超过853卡--持续5个月。
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,他们的全科医生会给他们进行强化指导,慢慢的让他们开始正常饮食(根据个人量身定制),持续2至8周。DiRECT的联合负责人Michael Lean指出:"在DiRECT中,40%的患者来自两个最贫困的社会经济群体,40%的患者服用6种或以上的药物治疗各种疾病。"毫无疑问,这是对治疗的严峻考验。
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