初级保健减重管理逆转2型糖尿病（DiRECT研究）

发布:2026年7月22日更新:2026年7月22日

Lean ME, Leslie WS, Barnes AC, Brosnahan N, Thom G, McCombie L等

The Lancet · 2018; 391(10120):541-551

本综述评估Primary care-led Counterweight-Plus programme: total diet replacement (825-853 kcal/day formula shakes/soups for 3-5 months), stepped food reintroduction (2-8 weeks), and structured long-term weight maintenance support with optional anti-obesity medication.与Remission of type 2 diabetes (HbA1c <6.5% / <48 mmol/mol after ≥2 months off all antidiabetic drugs) and weight loss ≥15 kg at 12 months的关系。纳入 306 例受试者。证据等级：Ib。

摘要速览

循证研究：初级保健减重管理逆转2型糖尿病

医学审核:WellAlly 编辑团队最后审核 2026年7月22日编辑政策

关键信息一览

DOI: 10.1016/s0140-6736(17)33102-1
PMID: 29221645
期刊: The Lancet
年份: 2018
卷: 391
期: 10120
页码: 541-551
研究类型: 指南
证据等级: Ib
样本量: 306
干预措施: Primary care-led Counterweight-Plus programme: total diet replacement (825-853 kcal/day formula shakes/soups for 3-5 months), stepped food reintroduction (2-8 weeks), and structured long-term weight maintenance support with optional anti-obesity medication.
主要终点: Remission of type 2 diabetes (HbA1c <6.5% / <48 mmol/mol after ≥2 months off all antidiabetic drugs) and weight loss ≥15 kg at 12 months
随访时长: 12 months
资金来源: foundation
效应量: Diabetes remission 46% vs 4% (OR 19.7, 95% CI 7.8-49.8); ≥15 kg weight loss 24% vs 0%
注册号: ISRCTN03267836
开放获取: 是

研究概述

本研究纳入 306 例受试者，探讨了Primary care-led Counterweight-Plus programme: total diet replacement (825-853 kcal/day formula shakes/soups for 3-5 months), stepped food reintroduction (2-8 weeks), and structured long-term weight maintenance support with optional anti-obesity medication.对Remission of type 2 diabetes (HbA1c <6.5% / <48 mmol/mol after ≥2 months off all antidiabetic drugs) and weight loss ≥15 kg at 12 months的影响。

关键发现

研究结果为Remission of type 2 diabetes (HbA1c <6.5% / <48 mmol/mol after ≥2 months off all antidiabetic drugs) and weight loss ≥15 kg at 12 months提供了重要证据。

临床结论

详见原始文献。证据等级：Ib。

Abstract

"本临床指南共纳入 306 例受试者，探讨了Primary care-led Counterweight-Plus programme: total diet replacement (825-853 kcal/day formula shakes/soups for 3-5 months), stepped food reintroduction (2-8 weeks), and structured long-term weight maintenance support with optional anti-obesity medication.对Remission of type 2 diabetes (HbA1c <6.5% / <48 mmol/mol after ≥2 months off all antidiabetic drugs) and weight loss ≥15 kg at 12 months的影响。

Funding & conflicts of interest

资金来源: foundation

COI: Some authors received grants and personal fees from Counterweight Ltd and other weight-management companies; Diabetes UK funded the trial.

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