收稿日期: 2024-04-07
网络出版日期: 2024-08-26
基金资助
国家重点研发计划项目(2018YFC1314100);广东省自然科学基金(2023A1515012321);广东省重点领域研发计划项目(2019B020230001);广州市科技计划项目(202002020053);广州地区临床特色项目(2023P-TS06)
Remission of type 2 diabetes： Contending perspectives and practical approaches
Received date: 2024-04-07
Online published: 2024-08-26
刘烈华 , 李延兵 . 2型糖尿病的缓解：百家争鸣与脚踏实地[J]. 实用医学杂志, 2024 , 40(16) : 2206 -2210 . DOI: 10.3969/j.issn.1006-5725.2024.16.002
In the early stages of type 2 diabetes， inducing remission of hyperglycemia has become a global hotspot in the field of diabetes management. In recent years， scholars from both domestic and international communities have established several remission intervention methods， including short-term intensive insulin therapy， lifestyle intervention， and metabolic surgery. They have also proposed theories such as beta-cell dedifferentiation and liver-pancreas “twin cycle” hypothesis， which have accelerated the growth of clinical and research information in this field. This review summarizes the clinical evidence， basic mechanisms， applicable populations， and exacutive principle points in the field of diabetes remission， with the aim of deepening the understanding of clinical practitioners about diabetes remission and laying the foundation for better practice and research in related fields.
Key words： type 2 diabetes mellitus; remission; abetes mellitus
| 1 | SUN H， SAEEDI P， KARURANGA S， et al. IDF Diabetes Atlas： Global， regional and country-level diabetes prevalence estimates for 2021 and projections for 2045［J］. Diabetes Res Clin Pract， 2022， 183：109119. doi:10.1016/j.diabres.2023.110945 |
| 2 | WANG L， GAO P， ZHANG M， et al. Prevalence and Ethnic Pattern of Diabetes and Prediabetes in China in 2013［J］. JAMA， 2017， 317（24）：2515-2523. doi:10.1001/jama.2017.7596 |
| 3 | LAITEERAPONG N， HAM S A， GAO Y， et al. The Legacy Effect in Type 2 Diabetes： Impact of Early Glycemic Control on Future Complications （The Diabetes & Aging Study）［J］. Diabetes Care， 2019， 42（3）：416-426. doi:10.2337/dci18-0036 |
| 4 | LIND M， IMBERG H， COLEMAN R L， et al. Historical HbA（1c） Values May Explain the Type 2 Diabetes Legacy Effect： UKPDS 88［J］. Diabetes Care， 2021， 44（10）：2231-2237. doi:10.2337/dc20-2439 |
| 5 | 纪立农. 活的更长、活得更好——糖尿病与“健康中国2030”［J］. 中国糖尿病杂志， 2019， 27（1）：1-2. |
| 6 | HOLMAN N， WILD S H， KHUNTI K， et al. Incidence and Characteristics of Remission of Type 2 Diabetes in England： A Cohort Study Using the National Diabetes Audit［J］. Diabetes Care， 2022， 45（5）：1151-1161. doi:10.2337/dc21-2136 |
| 7 | MINGRONE G， PANUNZI S， DE GAETANO A， et al. Metabolic surgery versus conventional medical therapy in patients with type 2 diabetes： 10-year follow-up of an open-label， single-centre， randomised controlled trial［J］. Lancet， 2021， 397（10271）：293-304. doi:10.1016/s0140-6736(20)32649-0 |
| 8 | SAUL H， DEENEY B， SWAITHES L， et al. Even short periods of diabetes remission are linked to lower risk of heart attack and stroke［J］. BMJ， 2024， 384：516. doi:10.1136/bmj.q516 |
| 9 | RIDDLE M C， CEFALU W T， EVANS P H， et al. Consensus Report： Definition and Interpretation of Remission in Type 2 Diabetes［J］. Diabetes Care， 2021， 44（10）：2438-2444. doi:10.2337/dci21-0034 |
| 10 | 中国胰岛素分泌研究组. 短期胰岛素强化治疗逆转2型糖尿病专家共识［J］. 中华糖尿病杂志， 2021， 13（10）：949-959. |
| 11 | 《缓解型糖尿病中国专家共识》编写专家委员会. 缓解2型糖尿病中国专家共识［J］. 中国全科医学， 2021， 24（32）：4037-4048. |
| 12 | 叶健华， 赵玉钏. 2型糖尿病缓解标准与治疗策略［J］. 实用医学杂志， 2023， 39（14）：1729-1732. doi:10.3969/j.issn.1006-5725.2023.14.001 |
| 13 | LI Y， XU W， LIAO Z， et al. Induction of long-term glycemic control in newly diagnosed type 2 diabetic patients is associated with improvement of beta-cell function［J］. Diabetes Care， 2004， 27（11）：2597-2602. doi:10.2337/diacare.27.11.2597 |
| 14 | WENG J， LI Y， XU W， et al. Effect of intensive insulin therapy on beta-cell function and glycaemic control in patients with newly diagnosed type 2 diabetes： a multicentre randomised parallel-group trial［J］. Lancet， 2008， 371（9626）：1753-1760. doi:10.1016/s0140-6736(08)60762-x |
| 15 | WANG H， KUANG J， XU M， et al. Predictors of Long-Term Glycemic Remission After 2-Week Intensive Insulin Treatment in Newly Diagnosed Type 2 Diabetes［J］. J Clin Endocrinol Metab， 2019， 104（6）：2153-2162. doi:10.1210/jc.2018-01468 |
| 16 | KRAMER C K， ZINMAN B， CHOI H， et al. Predictors of sustained drug-free diabetes remission over 48?weeks following short-term intensive insulin therapy in early type 2 diabetes［J］. BMJ Open Diabetes Res Care， 2016， 4（1）：e000270. doi:10.1136/bmjdrc-2016-000270 |
| 17 | KRAMER C K， ZINMAN B， RETNAKARAN R. Short-term intensive insulin therapy in type 2 diabetes mellitus： a systematic review and meta-analysis［J］. Lancet Diabetes Endocrinol， 2013， 1（1）：28-34. doi:10.1016/s2213-8587(13)70006-8 |
| 18 | 中华医学会糖尿病学分会. 中国2型糖尿病防治指南（2020年版）［J］. 中华糖尿病杂志， 2021， 13（4）：315-409. |
| 19 | PAN Y， HAN X， KAM H， et al. Nomogram for Predicting 5-Year Diabetes Remission After Roux-en-Y Gastric Bypass Surgery in Chinese Patients with Obesity［J］. Obes Surg， 2022， 32（5）：1556-1562. doi:10.1007/s11695-022-05952-x |
| 20 | IKRAMUDDIN S， KORNER J， LEE W J， et al. Lifestyle Intervention and Medical Management With vs Without Roux-en-Y Gastric Bypass and Control of Hemoglobin A1c， LDL Cholesterol， and Systolic Blood Pressure at 5 Years in the Diabetes Surgery Study［J］. JAMA， 2018， 319（3）：266-278. doi:10.1001/jama.2017.20813 |
| 21 | LEAN M E， LESLIE W S， BARNES A C， et al. Primary care-led weight management for remission of type 2 diabetes （DiRECT）： an open-label， cluster-randomised trial［J］. Lancet， 2018， 391（10120）：541-551. doi:10.1016/s0140-6736(17)33102-1 |
| 22 | TAHERI S， ZAGHLOUL H， CHAGOURY O， et al. Effect of intensive lifestyle intervention on bodyweight and glycaemia in early type 2 diabetes （DIADEM-I）： an open-label， parallel-group， randomised controlled trial［J］. Lancet Diabetes Endocrinol， 2020， 8（6）：477-489. doi:10.1016/s2213-8587(20)30117-0 |
| 23 | LEAN M E， LESLIE W S， BARNES A C， et al. 5-year follow-up of the randomised Diabetes Remission Clinical Trial （DiRECT） of continued support for weight loss maintenance in the UK： an extension study［J］. Lancet Diabetes Endocrinol， 2024， 12（4）：233-246. doi:10.1016/s2213-8587(23)00385-6 |
| 24 | TAYLOR R， AL-MRABEH A， SATTAR N. Understanding the mechanisms of reversal of type 2 diabetes［J］. Lancet Diabetes Endocrinol， 2019， 7（9）：726-736. doi:10.1016/s2213-8587(19)30076-2 |
| 25 | AL-MRABEH A， HOLLINGSWORTH K G， SHAW J， et al. 2-year remission of type 2 diabetes and pancreas morphology： a post-hoc analysis of the DiRECT open-label， cluster-randomised trial［J］. Lancet Diabetes Endocrinol， 2020， 8（12）：939-948. doi:10.1016/s2213-8587(20)30303-x |
| 26 | TAYLOR R， AL-MRABEH A， ZHYZHNEUSKAYA S， et al. Remission of Human Type 2 Diabetes Requires Decrease in Liver and Pancreas Fat Content but Is Dependent upon Capacity for β Cell Recovery［J］. Cell Metab， 2018， 28（4）：547-556.e3. doi:10.1016/j.cmet.2018.07.003 |
| 27 | ALBAUGH V L， AXELROD C， BELMONT K P， et al. Physiology Reconfigured： How Does Bariatric Surgery Lead to Diabetes Remission？［J］. Endocrinol Metab Clin North Am， 2023， 52（1）：49-64. doi:10.1016/j.ecl.2022.06.003 |
| 28 | YOSHINO M， KAYSER B D， YOSHINO J， et al. Effects of Diet versus Gastric Bypass on Metabolic Function in Diabetes［J］. N Engl J Med， 2020， 383（8）：721-732. doi:10.1056/nejmoa2003697 |
| 29 | CINTI F， BOUCHI R， KIM-MULLER J Y， et al. Evidence of β-Cell Dedifferentiation in Human Type 2 Diabetes［J］. J Clin Endocrinol Metab， 2016， 101（3）：1044-1054. doi:10.1210/jc.2015-2860 |
| 30 | WANG Z， YORK N W， NICHOLS C G， et al. Pancreatic beta cell dedifferentiation in diabetes and redifferentiation following insulin therapy［J］. Cell Metab， 2014， 19（5）：872-882. doi:10.1016/j.cmet.2014.03.010 |
| 31 | WANG Z， YORK N W， NICHOLS C G， et al. Pancreatic β cell dedifferentiation in diabetes and redifferentiation following insulin therapy［J］. Cell Metab， 2014， 19（5）：872-882. doi:10.1016/j.cmet.2014.03.010 |
| 32 | SACHS S， BASTIDAS-PONCE A， TRITSCHLER S， et al. Targeted pharmacological therapy restores β-cell function for diabetes remission［J］. Nat Metab， 2020， 2（2）：192-209. doi:10.1038/s42255-020-0171-3 |
| 33 | FURTH-LAVI J， HIJA A， TORNOVSKY-BABEAY S， et al. Glycemic control releases regenerative potential of pancreatic beta cells blocked by severe hyperglycemia［J］. Cell Rep， 2022， 41（9）：111719. doi:10.1016/j.celrep.2022.111719 |
| 34 | LIU L， KE W， XU L， et al. Evaluating the role of time in range as a glycemic target during short-term intensive insulin therapy in patients with newly diagnosed type 2 diabetes［J］. J Diabetes， 2023， 15（2）：133-144. doi:10.1111/1753-0407.13355 |
| 35 | XU L， ZHANG P， HUANG Z， et al. Hypoglycemia during Short-Term Intensive Insulin Therapy and Its Association with Long-Term Glycemic Remission in Patients with Newly Diagnosed Type 2 Diabetes［J］. J Diabetes Res， 2020， 2020：1-10. doi:10.1155/2020/4097469 |
| 36 | JACOB E， AVERY A. Energy-restricted interventions are effective for the remission of newly diagnosed type 2 diabetes： A systematic review of the evidence base［J］. Obes Sci Pract， 2021， 7（5）：606-618. doi:10.1002/osp4.504 |
| 37 | MCINNES N， HALL S， HRAMIAK I， et al. Remission of Type 2 Diabetes Following a Short-term Intensive Intervention With Insulin Glargine， Sitagliptin， and Metformin： Results of an Open-label Randomized Parallel-Design Trial［J］. Diabetes Care， 2022， 45（1）：178-185. doi:10.2337/dc21-0278 |
| 38 | RETNAKARAN R， CHOI H， YE C， et al. Two-year trial of intermittent insulin therapy vs metformin for the preservation of β-cell function after initial short-term intensive insulin induction in early type 2 diabetes［J］. Diabetes Obes Metab， 2018， 20（6）：1399-1407. doi:10.1111/dom.13236 |
| 39 | 刘烈华， 许丽娟， 柯伟健， 等. 短程胰岛素强化治疗后二甲双胍联合吡格列酮序贯治疗对新诊断2型糖尿病患者的作用［J］. 中华糖尿病杂志， 2020， 12（9）：696-701. doi:10.3760/cma.j.cn115791-20200224-00096 |
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