Effectiveness of a lifestyle modification programme in weight maintenance in obese subjects after cessation of treatment with Orlistat

OBJECTIVE: To examine the efficacy of a lifestyle modification programme in weight maintenance for obese subjects after cessation of treatment with Orlistat. METHODS: Fifty-five subjects with and without diabetes mellitus were randomized to a lifestyle modification programme or to usual care at the end of 6 months' treatment with Orlistat. The intervention programme was nutritionist led, consisting of components of dietary management, physical activity, peer group support and discussion using techniques of self-monitoring, stimulus control and cognitive restructuring. Anthropometric indices, body composition, basal metabolic rate, blood pressure, fasting glucose, glycosylated haemoglobin, lipid profile, 24-hour urinary albumin excretion, dietary intake, physical activity level, and quality of life were assessed before and after the intervention period. Results Subjects in the intervention group maintained their weight loss and favourable anthropometric, metabolic, dietary intake, physical activity and quality of life profiles, while most parameters deteriorated in the usual care group, being more marked in subjects with diabetes. The magnitude of weight gain was comparable to that lost during Orlistat treatment. CONCLUSION: A specially designed nutritionist-led lifestyle modification programme for obese subjects is effective in weight maintenance after treatment with Orlistat, in the absence of which the benefits of drug treatment were lost. The magnitude of the effect of lifestyle modification is comparable to that observed with Orlistat.     

Mediators of lifestyle behavior change in Native Hawaiians: initial findings from the Native Hawaiian Diabetes Intervention Program

OBJECTIVE: To examine the association of stage of change with diet and exercise behaviors in response to a lifestyle intervention for Native Hawaiians (NHs). RESEARCH DESIGN AND METHODS: A family ('ohana) support lifestyle intervention was compared with a standard intervention in NHs with or at risk for diabetes in two rural communities in Hawaii (n = 147). Stage of change, as a hypothesized mediator of behavior change, and dietary and exercise behaviors were measured at baseline and at 1 year postintervention. RESULTS: Stage of change was significantly associated with positive dietary and exercise behaviors. NHs receiving the 'ohana support (OS) intervention were more likely to advance from pre-action to action/maintenance for fat intake and physical activity than the group who received the standard intervention. Participants in the OS group who advanced from pre-action to action/maintenance showed more improvement in fat intake and physical activity than those in the standard group. CONCLUSIONS: These initial findings suggest that stage of change is an important factor in mediating lifestyle behavior changes in persons with or at risk for diabetes and merits further study among minority populations at high risk for diabetes.     

Early Lifestyle Intervention in Patients with Non-insulin-dependent Diabetes Mellitus and Impaire Glucose Tolerance

Non-insulin-dependent diabetes mellitus (NIDDM) is preceded by impaired glucose tolerance (IGT) lasting for years before manifesting as overt hyperglycaemia. Both genetic and environmental factors contribute to the development of IGT and NIDDM. Obesity, physical inactivity and high-fat diet have been found to predict IGT and NIDDM. Therefore, a diet and exercise intervention from diagnosis of NIDDM could improve the treatment outcome and prognosis of patients with NIDDM. Furthermore, because subjects with IGT are at increased risk for diabetes and atherosclerotic vascular diseases, it is reasonable to assume that in terms of reducing the incidence and long-term consequences of NIDDM an intervention at this phase is more effective than in overt diabetes. Although the nonpharmacological approach is generally accepted as the first-line treatment for NIDDM its efficacy has often been questioned. Therefore, it is important to carry out long-term controlled studies to find out to what extent lifestyle modification could improve the metabolic control and level of major cardiovascular risk factors known to be associated with poor outcome in NIDDM. This kind of study also gave relevant experience in planning studies aiming at primary prevention of NIDDM. One-year dietary and exercise intervention on newly diagnosed NIDDM patients in Kuopio, Finland resulted in a better metabolic control and a moderate reduction in cardiovascular risk factors as compared to the conventional treatment group. After the second year of follow-up only 12.5% in the intervention group were receiving oral antidiabetic drugs vs. 34.8% in the conventional treatment group. Weight reduction and a reduced use of saturated fats appeared to be the main determinants of successful treatment results. Good aerobic capacity was associated with an increase in HDL cholesterol. A multicentre primary prevention study on IGT patients is continuing in Finland applying the same principles of intervention as used in the study on newly diagnosed NIDDM patients. Pilot results show that glucose tolerance can be improved by lifestyle changes.     

饮食运动口诀在2型糖尿病患者管理中的应用与效果

目的 探讨糖尿病饮食运动口诀在2型糖尿病患者管理中的应用与效果.方法 选择2型糖尿病的住院患者200例,采用随机数字表分为观察组101例和对照组99例,对照组采用常规糖尿病饮食运动教育,观察组在常规健康教育的基础上,采用糖尿病饮食运动口诀并与食物模型、运动操培训相结合,采用互动式教育.结果 两组患者的空腹血糖、餐后2h血糖、糖化血红蛋白指标均有改善（P＜0.01或P＜0.05）;糖尿病饮食运动知识和生活方式干预依从性均有提高,且观察组均优于对照组（P＜0.01）.结论 采用糖尿病饮食运动口诀能使2型糖尿病患者更熟练、更正确地掌握糖尿病饮食运动方法,有利于控制患者血糖的各项指标.     

Intensive lifestyle changes are necessary to improve insulin sensitivity: a randomized controlled trial

OBJECTIVE: The extent to which lifestyle must be altered to improve insulin sensitivity has not been established. This study compares the effect on insulin sensitivity of current dietary and exercise recommendations with a more intensive intervention in normoglycemic insulin-resistant individuals. RESEARCH DESIGN AND METHODS: Seventy-nine normoglycemic insulin-resistant (determined by the euglycemic insulin clamp) men and women were randomized to either a control group or one of two combined dietary and exercise programs. One group (modest level) was based on current recommendations and the other on a more intensive dietary and exercise program. Insulin sensitivity was measured using a euglycemic insulin clamp, body composition was measured using dual-energy X-ray absorptiometry, and anthropometry and aerobic fitness were assessed before and after a 4-month intervention period. Four-day dietary intakes were recorded, and fasting glucose, insulin, and lipids were measured. RESULTS: Only the intensive group showed a significant improvement in insulin sensitivity (23% increase, P=0.006 vs. 9% in the modest group, P=0.23). This was associated with a significant improvement in aerobic fitness (11% increase in the intensive group, P=0.02 vs. 1% in the modest group, P=0.94) and a greater fiber intake, but no difference in reported total or saturated dietary fat. CONCLUSIONS: Current clinical dietary and exercise recommendations, even when vigorously implemented, did not significantly improve insulin sensitivity; however, a more intensive program did. Improved aerobic fitness appeared to be the major difference between the two intervention groups, although weight loss and diet composition may have also played an important role in determining insulin sensitivity.     

科学饮食调序护理在2型糖尿病患者中的应用研究

目的 观察科学饮食调序护理在2型糖尿病患者中的应用效果。 方法 选择2017年1-6月收住于我院的2型糖尿病病例76例作为研究对象,采用随机数字表法将其分为对照组和观察组,每组各38例,对照组接受常规护理,观察组接受科学饮食调序护理,比较2组干预后血糖值及饮食治疗依从率。 结果 干预后,观察组空腹及三餐后2 h血糖检测值均显著低于对照组,饮食治疗依从率显著高于对照组(Z=-2.629,P=0.009)。 结论 采用科学饮食调序护理对2型糖尿病患者施加干预,可有效提高患者对该饮食治疗方案依从性,获得较好的血糖控制效果。     

The Diabetes Prevention Program. Design and methods for a clinical trial in the prevention of type 2 diabetes

The Diabetes Prevention Program is a randomized clinical trial testing strategies to prevent or delay the development of type 2 diabetes in high-risk individuals with elevated fasting plasma glucose concentrations and impaired glucose tolerance. The 27 clinical centers in the U.S. are recruiting at least 3,000 participants of both sexes, approximately 50% of whom are minority patients and 20% of whom are > or = 65 years old, to be assigned at random to one of three intervention groups: an intensive lifestyle intervention focusing on a healthy diet and exercise and two masked medication treatment groups--metformin or placebo--combined with standard diet and exercise recommendations. Participants are being recruited during a 2 2/3-year period, and all will be followed for an additional 3 1/3 to 5 years after the close of recruitment to a common closing date in 2002. The primary outcome is the development of diabetes, diagnosed by fasting or post-challenge plasma glucose concentrations meeting the 1997 American Diabetes Association criteria. The 3,000 participants will provide 90% power to detect a 33% reduction in an expected diabetes incidence rate of at least 6.5% per year in the placebo group. Secondary outcomes include cardiovascular disease and its risk factors; changes in glycemia, beta-cell function, insulin sensitivity, obesity, diet, physical activity, and health-related quality of life; and occurrence of adverse events. A fourth treatment group--troglitazone combined with standard diet and exercise recommendations--was included initially but discontinued because of the liver toxicity of the drug. This randomized clinical trial will test the possibility of preventing or delaying the onset of type 2 diabetes in individuals at high risk.     

生活方式干预对糖尿病前期患者的效果观察

目的:分析对糖尿病前期患者进行社区干预的效果。方法:按照中国2型糖尿病防治指南中的标准,对上海市松江区某社区≥45岁的糖尿病高危人群进行筛查,并将其中自愿参加干预的162名糖尿病前期(impaired glucose regulation,IGR)患者随机分为两组:强化干预组(n=81)和对照组(n=81),前者接受强化教育和干预;后者只接受常规的健康教育。结果:干预1年后,两组吸烟率显著降低;强化干预组空腹血糖比对照组多下降了0.41mmol/L,且收缩压均值低于对照组;强化干预组的糖尿病转化率较对照组低16%(P<0.05)。结论:应对糖尿病前期人群积极进行健康教育,使其改变不良的生活方式,减少糖尿病的发生。     

Validation of a counseling strategy to promote the adoption and the maintenance of physical activity by type 2 diabetic subjects

OBJECTIVE: There is enough evidence that physical activity is an effective therapeutic tool in the management of type 2 diabetes. The present study was designed to validate a counseling strategy that could be used by physicians in their daily outpatient practice to promote the adoption and maintenance of physical activity by type 2 diabetic subjects. RESEARCH DESIGN AND METHODS: The long-term (2-year) efficacy of the behavioral approach (n = 182) was compared with usual care treatment (n = 158) in two matched, randomized groups of patients with type 2 diabetes who had been referred to our Outpatient Diabetes Center. The outcome of the intervention was consistent patient achievement of an energy expenditure of >10 metabolic equivalents (METs)-h/week through voluntary physical activity. RESULTS: After 2 years, 69% of the patients in the intervention group (27.1 +/- 2.0 METs x h/week) and 18% of the control group (4.1 +/- 0.8 METs x h/week) achieved the target (P < 0.001) with significant (P < 0.001) improvements in BMI (intervention group 28.9 +/- 0.2 versus control group 30.4 +/- 0.3 kg/m(2)) and HbA(1c) (intervention group 7.0 +/- 0.1 versus control group 7.6 +/- 0.1%). CONCLUSIONS: This randomized, controlled study shows that physicians can motivate most patients with type 2 diabetes to exercise long-term and emphasizes the value of individual behavioral approaches in daily practice.     

Long-term (5-year) effects of a reduced-fat diet intervention in individuals with glucose intolerance

OBJECTIVE: To determine whether reducing dietary fat would reduce body weight and improve long-term glycemia in people with glucose intolerance. RESEARCH DESIGN AND METHODS: A 5-year Follow-up of a 1-year randomized controlled trial of a reduced-fat ad libitum diet versus a usual diet. Participants with glucose intolerance (2-h blood glucose 7.0-11.0 mmol/l) were recruited from a Workforce Diabetes Survey. The group that was randomized to a reduced-fat diet participated in monthly small-group education sessions on reduced-fat eating for 1 year. Body weight and glucose tolerance were measured in 136 participants at baseline 6 months, and 1 year (end of intervention), with follow-up at 2 years (n = l04), 3 years (n = 99), and 5 years (n = 103). RESULTS: Compared with the control group, weight decreased in the reduced-fat-diet group (P < 0.0001); the greatest difference was noted at 1 year (-3.3 kg), diminished at subsequent follow-up (-3.2 kg at 2 years and -1.6 kg at 3 years), and was no longer present by 5 years (1.1 kg). Glucose tolerance also improved in patients on the reduced-fat diet; a lower proportion had type 2 diabetes or impaired glucose tolerance at 1 year (47 vs. 67%, P < 0.05), but in subsequent years, there were no differences between groups. However, the more compliant 50% of the intervention group maintained lower fasting and 2-h glucose at 5 years (P = 0.041 and P = 0.026 respectively) compared with control subjects. CONCLUSIONS: The natural history for people at high risk of developing type 2 diabetes is weight gain and deterioration in glucose tolerance. This process may be ameliorated through adherence to a reduced fat intake     

电话加短信随访对2型糖尿病患者生活方式和行为习惯的影响

目的探讨电话加短信随访对2型糖尿病患者生活方式和行为习惯的影响。方法将200例2型糖尿病患者分为随访组和对照组,每组100例。所有患者住院期间按2型糖尿病诊疗常规进行治疗护理,出院后随访组定期电话加短信随访,对照组门诊随访,干预24个月后观察患者生活方式和行为习惯的变化及血糖控制效果。结果在出院第12个月末,随访组患者饮食控制和疾病认知的改善优于对照组(P0.05);在出院后第24个月末,随访组生活方式和行为习惯各条目的改善均优于对照组(P0.01或P0.05);在出院后第6、12、18、24个月末,随访组血糖控制优于对照组(P0.01)。结论电话加短信随访干预有助于改善2型糖尿病患者生活方式和行为习惯,有利于血糖控制。     

Lifestyle intervention to prevent gestational diabetes mellitus and adverse maternal outcomes among pregnant women at high risk for gestational diabetes mellitus

ObjectiveWe assessed the effects of a lifestyle intervention on gestational diabetes mellitus (GDM) incidence and risk of adverse maternal outcomes among pregnant women at high risk for GDM.MethodsFrom July to December 2018, we enrolled 1822 eligible pregnant women; of these, 304 had at least one risk factor for GDM. Participants were randomly allocated to the intervention or control group. Usual prenatal care was offered to both groups; the intervention group also received individually modified education on diet, physical activity, and weight control. The GDM diagnosis was based on an oral glucose tolerance test at 24–28 gestational weeks. Multivariate logistic regression was used to evaluate the effects of the lifestyle intervention on risk of GDM and adverse maternal outcomes.ResultsA total of 281 women (139 in the intervention group and 142 controls) were included. Incidences of GDM and adverse maternal outcomes were all significantly lower in the intervention than in the control group. Multivariate logistic regression indicated that women in the intervention group had a lower risk of GDM and adverse maternal outcomes, after adjusting potential confounding factors.ConclusionThe present lifestyle intervention was associated with lower risks of GDM and adverse maternal outcomes.     

量化运动对代谢综合征干预疗效观察

目的观察生活方式对代谢综合征（MS）发病率的影响,探讨量化运动干预对MS的疗效。方法以2008年1月至2009年12月深圳市慢性病防治中心健康体检的人群作为观察对象,选取有效观察对象256例,根据生活方式、工作劳动强度、身体活动问卷调查将观察对象分成积极运动生活方式及静坐生活方式组,分析不同运动生活方式对MS患病率的影响。选取新发MS患者58例随机分为运动干预组（A组）29例即采取运动干预联合基础药物治疗,基础药物干预组（B组）29例仅采取基础药物治疗,两组病例分别于干预前、干预后3个月、6个月检测体质量指数、血压、血糖、血脂,观察两组干预疗效。结果积极运动生活方式组MS发病率为12.3%,明显低于静坐生活方式组MS发病率（31%）,量化运动干预组体质量指数下降明显,其3个月、6个月MS控制达标率分别为86.2%、93.1%,明显高于基础药物干预组的69.0%、82.8%（P〈0.05）。结论积极运动生活方式是MS的保护因素,多食少动的生活方式是MS发生的不良因素,加强健康教育,改变不健康生活方式,可有效预防MS发生。     

社区老年糖尿病35例程序式居家护理

目的:探讨程序式居家护理对社区老年糖尿病患者血糖控制及治疗依从性的影响.方法:将70例社区老年糖尿病患者随机分为居家组和对照组各35例,居家组给予程序式居家护理,对照组给予常规社区护理,均干预6个月,比较两组干预效果.结果:居家组干预后血糖控制效果与对照组比较差异有统计学意义(P<0.05),居家组治疗依从性中用药、饮食及运动依从性与对照组比较差异有统计学意义(P<0.05).结论:程序式居家护理可提高社区老年糖尿病患者的治疗依从性和血糖控制效果,值得推广应用.     

行为转变理论在空腹血糖受损人群生活方式干预中的应用

目的探讨行为转变理论(trans-theoretical model of behavior,TTM)在空腹血糖受损(impaired fasting glucose,IFG)人群生活方式干预中的应用效果。方法便利抽样法选取2012年3月至2013年3月在无锡市人民医院体检中心体检且符合IFG诊断的40例患者为研究对象。由研究团队根据TTM理论,制定综合、分阶段干预措施,一对一进行为期1年的运动、医学营养、糖尿病知识和心理等干预,使其逐步建立合理的饮食结构及适当的运动量,形成健康的生活方式。结果应用TTM方法干预生活方式后,IFG人群体质量指数(body mass index,BMI)、收缩压、舒张压、三酰甘油(triglyceride,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白(low density lipoprotein,LDL)、空腹血糖(fasting plasma glucose,FPG)明显低于干预前,差异均有统计学意义(均P0.05);但是腰围(waist circumference,WC)、高密度脂蛋白(high-density lipoprotein,HDL)较干预前好转不明显,差异均无统计学意义(均P0.05)。干预后,IFG人群三餐饮食搭配合理例数明显高于干预前,差异有统计学意义(P0.01)。每天摄入三种主要营养素、食用油、食盐、蔬菜摄入的合理例数明显高于干预前,差异有统计学意义(P0.01)。IFG人群每天有效运动时间、总运动量、有效运动量均明显增加,与干预前比较,差异均有统计学意义(均P0.01)。结论应用TTM干预有助于帮助IFG人群逐步建立和维持合理的膳食、适当的运动、改善代谢指标,从而降低发病危险因素,达到健康的生活方式,逐步从源头上控制2型糖尿病的发生与发展。     

Randomized controlled community-based nutrition and exercise intervention improves glycemia and cardiovascular risk factors in type 2 diabetic patients in rural Costa Rica

OBJECTIVE: The prevalence of type 2 diabetes, especially in developing countries, has grown over the past decades. We performed a controlled clinical study to determine whether a community-based, group-centered public health intervention addressing nutrition and exercise can ameliorate glycemic control and associated cardiovascular risk factors in type 2 diabetic patients in rural Costa Rica. RESEARCH DESIGN AND METHODS: A total of 75 adults with type 2 diabetes, mean age 59 years, were randomly assigned to the intervention group or the control group. All participants received basic diabetes education. The subjects in the intervention group participated in 11 weekly nutrition classes (90 min each session). Subjects for whom exercise was deemed safe also participated in triweekly walking groups (60 min each session). Glycosylated hemoglobin, fasting plasma glucose, total cholesterol, triglycerides, HDL and LDL cholesterol, height, weight, BMI, and blood pressure were measured at baseline and the end of the study (after 12 weeks). RESULTS: The intervention group lost 1.0 +/- 2.2 kg compared with a weight gain in the control group of 0.4 +/- 2.3 kg (P = 0.028). Fasting plasma glucose decreased 19 +/- 55 mg/dl in the intervention group and increased 16 +/- 78 mg/dl in the control group (P = 0.048). Glycosylated hemoglobin decreased 1.8 +/- 2.3% in the intervention group and 0.4 +/- 2.3% in the control group (P = 0.028). CONCLUSIONS: Glycemic control of type 2 diabetic patients can be improved through community-based, group-centered public health interventions addressing nutrition and exercise. This pilot study provides an economically feasible model for programs that aim to improve the health status of people with type 2 diabetes.     

家属同步管理在精神障碍患者伴发代谢综合征高危因素中的应用研究

探讨家属同步管理对长期住院精神分裂症患者伴发代谢综合征高危因素中的作用。方法 对100例男性住院精神分裂症患者随机分为干预组和对照组各50例,对照组采用常规护理方法,干预组在饮食干预、运动干预的基础上,进行家属同步管理,分别比较干预前后两组患者的代谢综合征各类指标与运动时间。结果 经过6个月的干预,两组患者在腰围、体重、三酰甘油、血糖等指标比较差异有统计学意义（P＜0.05）,运动时间与对照组有显著增加。结论 通过家属同步管理,可以有效改变长期住院精神分裂症患者的不良生活方式,降低伴发代谢综合征的高危因素,提高医患互动,促进医患关系。     

Supervised exercise program, BMI, and risk of type 2 diabetes in subjects with normal or impaired fasting glucose

OBJECTIVE

To determine the association of regular exercise, BMI, and fasting glucose with the risk of type 2 diabetes and to predict the risk.

RESEARCH DESIGN AND METHODS

Korean subjects (n = 7,233; 40–79 years old) who were not diagnosed with diabetes at baseline were enrolled through the National Health Insurance Corporation. All participants underwent biennial examinations, and 1,947 of 7,233 subjects also underwent a 6-month program of moderate-intensity exercise (300 min/week) without dietary advice.

RESULTS

During follow-up (mean = 2 years), there were 303 incidents of type 2 diabetes in the nonexercise program group (n = 5,286) and 83 in the exercise program group (n = 1,947). After adjusting for confounders, the risk of type 2 diabetes was positively associated with BMI and inversely with regular exercise, especially among overweight/obese subjects. After further adjustment for BMI, the odds ratios for risk of diabetes associated without and with regular exercise were 1.00 and 0.77, respectively. Among subjects with normal fasting glucose, exercise reduced the diabetes risk; however, among those with impaired fasting glucose (IFG), the protective effect of exercise was found only among overweight/obese subjects. The overweight/obese subjects in the exercise program group exhibited improved fasting glucose compared with the nonexercise program group and showed 1.5 kg of weight loss and a 3-cm decrease in waist circumference. Among overweight/obese subjects with unchanged fasting glucose, weight loss was greater in the exercise program group.

CONCLUSIONS

Regular exercise reduces the risk of type 2 diabetes in overweight/obese individuals. Particularly, regular exercise and weight or waist circumference control are critical factors for preventing diabetes in overweight/obese individuals with IFG.The benefits of exercise in preventing and treating type 2 diabetes are widely recognized (1). Exercise improves glycemic control, body composition, cardiorespiratory fitness, cardiovascular risk, physical functioning, and well-being in patients with type 2 diabetes or prediabetes (1–3). Regular exercise is therefore a key strategy in diabetes prevention. A number of large-scale, randomized, controlled trials have been performed to evaluate the effect of lifestyle modification in prediabetic populations (4–10), with the aim of reducing the incidence of type 2 diabetes and ameliorating risk factors associated with this disease. These lifestyle interventions, which generally included both physical activity and nutritional interventions, have been highly successful in preventing the onset of type 2 diabetes. Studies that failed to show improved glycemic control typically reported poor exercise compliance (11) or low-intensity exercise (12). However, most physical activity intervention studies focused on English speakers. Additional studies are needed to characterize ethnic and/or cultural differences in the risk of type 2 diabetes because most studies show lower physical activity levels in nonwhite compared with white populations (13). Accordingly, tailor-made interventions that take into account the different needs of various groups (e.g., language and culture) should be developed and evaluated. In this prospective cohort study, we evaluated the association of regular exercise, BMI, and glucose levels with the risk of type 2 diabetes in a Korean population. The exercise program was prescribed and delivered by qualified health professionals.     

阿卡波糖和食物纤维在糖耐量减低人群向2型糖尿病发展中的干预作用

目的:观察阿卡波糖和食物纤维预防糖耐量低减(IGT)人群进展为2型糖尿病(DM)的作用。方法:以口服75g葡萄糖耐量试验(OGTT)确诊(WHO标准)的IGT213例中男156例,女57例。入选者年龄35岁以上,体重指数(BMI)在19kg/m2以上。分为对照组52例,教育组37例,食物纤维组64例,阿卡波糖组60例。对照组进行一般的健康教育;教育组进行饮食指导,每半年1次;食物纤维组除健康教育外,每日口服食物纤维12g;阿卡波糖组每日口服阿卡波糖0.15g,分3次餐时口服。对4组参试者每半年作1次OGTT,同时测身高、体重、BMI、12h尿蛋白,复查日当天不服干预药物或食物纤维。共观察3年。若2次OGTT或最后1次复查结果为DM,则判断为已发展为DM。结果:213例IGT在观察中有18例(8.5%)退出。空腹血糖(FBS)和服糖后1h血糖(1hPBS)在对照组、教育组和食物纤维组均较治疗前略有升高,但在阿卡波糖治疗组均有下降。4组间FBS比较F=8.126,P<0.01,4组间1hPBS比较F=3.706,P=0.012。观察期末对照组12例(26.7%)、教育组7例(21.9%)、食物纤维组10例(16....