减重如何逆转糖尿病？《柳叶刀》子刊重磅公布代谢修复新突破

Core Insights - The article discusses the significant impact of scientific weight loss on reversing type 2 diabetes, highlighting that nearly half of the patients can achieve complete remission through effective weight management strategies [6][7]. Group 1: Key Research Findings - A 2023 meta-analysis indicates that greater weight loss correlates with more significant diabetes remission, with a 5% weight loss reducing diabetes risk by 58% and a 10% weight loss improving insulin sensitivity by up to 70% [7]. - The DiRECT study shows that a low-calorie meal replacement plan (800-1000 kcal/day) for 12 weeks led to a 46% remission rate after one year, with 10% maintaining remission after five years despite some weight regain [9]. - A ten-year follow-up on gastric bypass surgery revealed that over 50% of patients with a weight loss of 15% or more achieved complete remission, with 37% remaining off medication after ten years [10][11]. Group 2: Weight Loss Strategies - The recommended weight loss formula suggests losing 10% of body weight in three months and 15% in one year, emphasizing a daily caloric deficit of 500 kcal [13]. - A four-step dietary approach includes time-restricted eating, low-carb high-fiber meals, adequate protein intake, and choosing low-glycemic carbohydrates to stabilize blood sugar levels [14]. - An effective exercise regimen involves 150 minutes of aerobic activity weekly and strength training twice a week to enhance glucose utilization [15]. Group 3: Common Weight Loss Pitfalls - Rapid weight loss is discouraged as it can lead to muscle loss and increased chances of weight regain; a controlled weight loss of 0.5-1 kg per week is recommended [16]. - Following trendy diets without scientific backing, such as ketogenic diets, may lead to adverse health effects, including increased LDL cholesterol [17]. - Long-term weight management is crucial, as about 60% of successful weight losers regain weight within five years; regular monitoring of waist circumference and visceral fat is advised [18]. Group 4: Successful Weight Loss Candidates - Individuals diagnosed with diabetes for less than five years and with preserved pancreatic function are more likely to succeed in weight loss efforts [19]. - High adherence to dietary and exercise plans significantly increases the chances of successful weight loss, with compliance rates above 80% doubling success rates [20].