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逆转2型糖尿病,你应该知道什么呢?

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  • TA的每日心情
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    [LV.10]灵魂人物

    发表于 2018-10-27 07:57:24 | 显示全部楼层 |阅读模式
    本帖最后由 wildox 于 2018-10-27 14:42 编辑

    What You Need to Know About Reversing Type 2 Diabetes

    If you’ve been diagnosed with type 2 diabetes, you may be asking yourself if it can be reversed, and if so, how? In this article, we cover the main factors involved and discuss the main strategy that can help control (and in some cases, even reverse) type 2 diabetes.

    Can Type 2 Diabetes Be Reversed?
    Type 2 diabetes is often considered to be a progressive disease. However, it is well-established that the progression can be halted, and in many cases, the disease can be reversed.
    “Type 2 diabetes has long been regarded as inevitably progressive, requiring increasing numbers of oral hypoglycemic agents and eventually insulin, but it is now certain that the disease process can be halted with restoration of normal carbohydrate and fat metabolism. Type 2 diabetes can be understood as a potentially reversible metabolic state precipitated by the single cause of chronic excess intraorgan fat,”experts describe.
    One study published in the journal Diabetologia described that beta cell function (as measured by insulin levels) and fasting blood glucose levels can be completely normalized solely by decreasing dietary intake. The authors describe that “after 1 week of dietary intervention, fasting plasma glucose decreased from 9.2 ± 0.4 to 5.9 ± 0.4 mmol/l and was not significantly different from that of the non-diabetic control group [and] it remained stable for the rest of the 8 week study.” Although this particular study demonstrated very striking results, the interpretations are hindered by the very small sample size (n=11).
    Is reversing type 2 diabetes achievable in all cases? In a word, no.
    A recently published clinical trial describes a “return and persistence of non-diabetic blood glucose control in 46% of people with type 2 diabetes of up to 6 years duration” following weight management intervention. However, since the researchers define “non-diabetic” as those who achieved an A1c level of <6.5%, some of the participants were still in the pre-diabetic blood glucose ranges following the intervention. In another recent publication, the authors also noted that “return to non-diabetic glucose control depends upon beta cell ability to recover.”
    In any case, if you have type 2 diabetes and are overweight, losing weight can help you achieve better blood glucose control and improve other health parameters as well.

    Weight Loss to Reverse Type 2 Diabetes
    As presented above, it appears that weight loss is the primary way to effectively treat, and sometimes reverse type 2 diabetes. Importantly, at least one study described that weight loss needs to exceed 5% to be beneficial. So, how does one go about losing substantial amounts of weight to help with type 2 diabetes management or even achieve remission?
    Dietary Changes
    Although it is well-accepted that diet is the main variable when it comes to weight management for most individuals, the jury is still out on which diet is the best one for weight loss. In general, a hypocaloric diet (caloric deficit) has been shown time and time again to be an effective strategy.

    Recent research presented at the 78th American Diabetes Association (ADA) Scientific Sessions reported on a randomized controlled trial that compared a high-carbohydrate diet to a low-carbohydrate diet (that was also low in saturated fat). Here is a summary of the study outcomes:
    “The drop-out rate (~50%) was not significantly different between the two groups, and the researchers confirmed that the remaining participants adhered to the prescribed diets.
    While the data showed a comparable reduction in A1c (~1%), weight, and similar body composition, the participants in the low-carbohydrate group:
    • Lowered their medication use by more than two-fold compared to the high-carbohydrate group
    • Experienced a greater than two-fold reduction in glycemic variability parameters compared to the high-carbohydrate group
    • Experienced a greater reduction in triglycerides than the high-carbohydrate group
    Both groups experienced comparable decreases in blood pressure, insulin use, insulin resistance, and c-reactive protein levels (a marker of inflammation).”
    So, while weight loss and associated improvement in type 2 diabetes can be achieved with caloric restriction and using a variety of dietary approaches, some recent research points to additional benefits of carbohydrate restriction.
    It is very important to talk to your health care provider or nutritionist before making changes to your diet. Your medical team can help ensure that you are still getting all the necessary nutrients.

    Bariatric Surgery
    The notion that type 2 diabetes may be entirely reversible was first proposed based on observations of bariatric surgery patients. “Almost a quarter century ago [it was] demonstrated that blood glucose levels normalized in obese people with type 2 diabetes undergoing bariatric surgery and that 10 years later, almost 90% remained free of diabetes,” researchers describe.
    Moreover, a randomized controlled study demonstrated its efficacy for weight loss and subsequent reversal of type 2 diabetes (n=60). The authors of that study note that the greatest blood glucose improvements were achieved in the patients who lost the most weight.


    Therapeutic Fasting
    Interestingly, some researchers believe that fasting can be a useful tool for patients with type 2 diabetes when it comes to weight management and blood glucose control. After noting the efficacy of bariatric surgery, one case study reporting on therapeutic fasting in a patient with type 2 diabetes noted that “fasting may be an effective, natural alternative dietary treatment, offering similar caloric restriction and hormonal benefits [as bariatric surgery] without the cost or invasiveness of surgical intervention.” The authors also stated that the efficacy of intermittent fasting for weight loss has been consistently demonstrated in the literature.
    Exercise
    In general, exercise programs are not nearly as important as the diet when it comes to weight loss, although exercise does offer a multitude of other health benefits (e.g., cardiovascular and mental health benefits). While exercise can promote some weight loss, researchers summarize that “based on the present literature, unless the overall volume of aerobic exercise training is very high, clinically significant weight loss is unlikely to occur.”

    One clinical trial demonstrated that high-intensity intermittent exercise (HIIT) was effective in reducing liver fat, which can help improve type 2 diabetes. However, although the authors noted that while patients improved their cardiovascular parameters, they only saw “modest improvements” in blood glucose levels.
    Talk to your doctor before you begin a new exercise routine. Your medications may need to be adjusted, and your health care practitioner will take your individual circumstances into consideration when making a recommendation about a particular exercise program.
    Conclusions
    Based on the available research, weight loss is the primary effective method known to control and even reverse type 2 diabetes. Working with your healthcare team to find a plan that works well for you is key. Finding peer support by connecting with others who have a similar goal in a formal intervention program or in an informal setting, such as a forum, can also help.





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    发表于 2018-10-27 11:46:56 来自手机 | 显示全部楼层
    没错,减肥最有效果,低碳也没问题,但生酮与否我还在犹豫。
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    [LV.5]小有名气

    发表于 2018-10-27 18:49:26 来自手机 | 显示全部楼层
    好像还没有什么新的方案
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    [LV.9]家园元老

    发表于 2018-10-27 19:02:55 | 显示全部楼层
    英文。。。
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  • TA的每日心情
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    2018-10-31 10:38
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    [LV.1]初来乍到

    发表于 2018-10-31 10:37:33 | 显示全部楼层
    有点道理, 不过那个结论太模糊, 估计治愈很难没法定论, 哈哈
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  • TA的每日心情
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    2018-8-28 17:53
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    [LV.2]家园少年

    发表于 2018-11-4 16:19:33 | 显示全部楼层
    说的不错...
    来自苹果客户端
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  • TA的每日心情
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    [LV.2]家园少年

    发表于 2018-11-6 18:02:26 | 显示全部楼层
    皇家翻译说个大概呗
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