首页 国际内分泌代谢杂志 2024年44卷05期 2型糖尿病患者体重管理专家共识(2024年版)
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2型糖尿病患者体重管理专家共识(2024年版)
《2型糖尿病患者体重管理专家共识》专家组 
作者及单位信息
·
DOI： 10.3760/cma.j.cn121383-20240514-00022
Experts consensus on weight management for type 2 diabetes mellitus(2024 edition)
Expert Group for Expert Consensus on weight management for type 2 diabetes mellitus
Mu Yiming
Zhao Jiajun
Authors Info & Affiliations
Expert Group for Expert Consensus on weight management for type 2 diabetes mellitus
Mu Yiming
Zhao Jiajun
·
DOI： 10.3760/cma.j.cn121383-20240514-00022
1822
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摘要
2型糖尿病(type 2 diabetes mellitus，T2DM)的体重管理重要且复杂。临床实践中，T2DM合并超重或肥胖者常见，应予以充分重视。控制超重或肥胖的基础上，还应注重体重管理的质量。单纯以体重指数作为肥胖的评价指标不够全面和客观，因此，减重治疗还应评估患者身体成分(尤其是内脏脂肪)的改变，以"减脂增肌"为目的；另一方面，对于体型消瘦的T2DM患者，要充分评估肌肉脂肪占比，合理饮食运动及药物治疗；同时尽量减少或避免减重过程中的体重波动，使体重长期维持在目标水平。对于肌少性肥胖患者应注意合理饮食运动管理。总之，肥胖T2DM患者的减重治疗会改善患者的综合代谢及远期获益；同时，在T2DM体重管理临床实践中，还应该注意对体重波动、体重过轻及肌少性肥胖等患者的合理干预，以综合管理T2DM患者的体重。
糖尿病，2型;体重波动;内脏脂肪;肌少症;肌少性肥胖;营养不良
ABSTRACT
Weight management is pivotal and complicated in the comprehensive management of type 2 diabetes mellitus (T2DM). In clinical practice, T2DM combined with overweight or obesity is more common. On the basis of controlling overweight or obesity, the quality of weight management should be emphasized. Simply using body mass index as evaluating indicator of obesity is not comprehensive and objective. Therefore, the dynamic changes of body composition especially visceral fat should be evaluated for the purpose of reducing fat and increasing muscle; Other the other hand, for T2DM with underweight, it is necessary to fully evaluate the proportion of muscle and fat, and to adopt reasonable dietary, exercise, and medication interventions. Meanwhile, avoiding the weight fluctuation during weight loss can contribute to long term target of body weight. Sarcopenic obesity should be carried out reasonable dietary and exercise interventions. In summary, weight loss treatment for T2DM with obesity can improve overall metabolism and long-term benefits. At the same time, in the clinical practice of weight management for T2DM, reasonable interventions should be taken for management of weight fluctuation, underweight and sarcopenic obesity, to achieve comprehensive management of T2DM weight.
Diabetes mellitus, Type 2;Body weight fluctuation;Visceral fat;Sarcopenia;Sarcopenic Obesity;Malnutrition
Mu Yiming, Email:
nc.defmoabc.latipsoh103gnimiyum;
Zhao Jiajun, Email:
nc.defudabe.udsoahzjj
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《2型糖尿病患者体重管理专家共识》专家组. 2型糖尿病患者体重管理专家共识(2024年版)[J]. 国际内分泌代谢杂志,2024,44(05)：359-370.
DOI:10.3760/cma.j.cn121383-20240514-00022PERMISSIONS
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体重管理是2型糖尿病(type 2 diabetes mellitus, T2DM)综合治疗的重要组成部分，而"肥胖悖论"揭示了体重管理的复杂性。临床实践中，T2DM合并超重或肥胖患者进行减重治疗非常重要，另一方面，减重同时还应注重对身体成分的改变、体重波动等情况进行评估；对于T2DM体重过低的患者，也应予以充分重视和考量。因此，专家组在2022年已有共识的基础上，依据近2年来全球T2DM患者体重管理的最新进展，重新制定了此新的共识，以期继续帮助广大医务工作者对T2DM的体重管理策略提供更为全面的认识和参考。
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