早期识别超重高血糖可改善2型糖尿病的临床预后

Anand Chockalingam, Pandiyan Natarajan, Smrita Dorairajan, Uzma Khan
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引用次数: 1

摘要

糖尿病是第九大死因,每年直接导致全世界150万人死亡。尽管有一些突破性的发现,但在过去的100年里,2型糖尿病的治疗进展甚微。年龄较小(60岁以下),高热量饮食和加工食品,以及严重肥胖(体重指数>35 kg/m2)可识别可逆性β细胞功能障碍。许多临床表现与营养过剩淹没身体的适应极限有关。认识到这是生活方式改变、久坐不动的工作、精神压力和无限获取高热量食物所带来的全球社会趋势是至关重要的。胰岛素抵抗和基因异常不能解释糖尿病的急剧增加,从50年前的1%到今天的近10%。肥胖——而不是胰岛素抵抗——才是问题的核心。与高血糖一样,终末器官损伤也可以通过饮食和减肥来逆转。我们提出了我们的理解的演变和令人信服的理由,将严重肥胖的糖尿病重新定义为它的真实面目-超重高血糖。这可能会改变社会观念、政府资助、工作场所改革和个人对健康生活方式的参与。本综述的目的是更好地了解全球趋势,并通过重塑糖尿病缓解叙事来改善预后的潜力。这可能会改变社会观念、政府资助、工作场所改革和个人对健康生活方式的参与。
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Early Recognition of Overweight Hyperglycaemia May Improve Clinical Outcomes in Type 2 Diabetes.

Diabetes is the ninth leading cause of death, directly accounting for 1.5 million deaths annually worldwide. Despite several breakthrough discoveries, little progress has been made in type 2 diabetes outcomes over the past 100 years. Younger age (below 60 years), a diet high in calories and processed food, and severe obesity (body mass index >35 kg/m2) may identify reversible beta cell dysfunction. Much of the clinical presentation pertains to flooding the body's adaptive limits with overnutrition. Recognizing this as a global societal trend brought about by lifestyle changes, sedentary work, mental stress and unlimited access to calorie-dense foods is crucial. Insulin resistance and genetic abnormalities cannot account for the dramatic increase in diabetes, from only 1% five decades ago to nearly 10% today. Obesity - and not insulin resistance - is at the core of the problem. As well as hyperglycaemia, end-organ damage can also be reversed with diet and weight loss in many affected individuals. We present the evolution of our understanding and compelling reasons to reframe diabetes in the severely obese to what it really is - overweight hyperglycaemia. This may shift societal perception, governmental funding, workplace reformations and individual engagement with healthy lifestyles. The objective of this review is to better understand global trends and the potential to improve outcomes by reframing the diabetes narrative towards remission. This may shift societal perception, governmental funding, workplace reformations and individual engagement with healthy lifestyles.

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