糖尿病與肥胖是心血管疾病的高危險群。美國糖尿病學會（ADA）建議糖尿病患需要控制血糖、血脂及血壓才能預防或延緩心血管疾病的發生。本研究目的係針對第2型糖尿病患的體重變化對血糖、血壓及血脂的影響進行一系列相關性探討。自2004-2006年採行便利性取樣方法運用於篩選在醫院門診接受糖尿病控制的過重或肥胖的患者，每位受試者皆經過ㄧ年的追蹤，觀察體重的變化，若體重減少者歸類為減重組體重；增加或無變化者歸類為增加組。比較其前後血糖、血壓與血脂的改變情形，依據2006年ADA的建議A1C<7.0 %、TG<150 mg/dl、LDL-C<100 mg/dl、HDL>35 mg/dl及血壓<130/80 mmHg共五項目標值，分別比較兩組的完成率。研究結果發現體重減少組與增加組在一年後空腹血糖、糖化血色素、三酸甘油酯、膽固醇及血壓皆有降低趨勢，但兩組無顯著差異。並比較達到ADA建議目標值四項以上的各組人數差異性，發現以減重組顯著的高於增加組。本研究結果發現具有企圖心完成照顧網計畫的糖尿病患者，在體重不論增加或減少的情形下，對於血糖、血脂及血壓均能有效地控制，而體重減輕的患者比體重增加的患者更能達ADA建議的目標值，對於預防或減緩心血管疾病的危險發生率有更佳的效果。 Diabetes and obesity are known to increase the risk of cardiovascular disease (CVD). The American Diabetes Association (ADA) has suggested that type 2 diabetes need to control their glycemia, lipid and blood pressure to prevent of cardiovascular diseases. The present study aimed to conduct a systematic evaluation on the effects of weight changes on glycemia, lipid and blood pressure in patients with type 2 diabetes. From 2004 to 2006, convenience sampling method was used to screen for overweight or obese patients with type 2 diabetes. Patients accepted for the study were traced for a year to observe for weight changes and then categorized into two groups; group one was those achieved body weight loss group two having no change or increase in weight. Differences in these measurements within and between groups were compared based on recommended by ADA in 2006, i.e. HbA1c < 7.0 %, TG < 150 mg/dl, LDL < 100 mg/dl, HDL > 35 mg/dl and blood pressure < 130/80 mmHg. Results showed that fasting blood sugar , HbA1c, TG, cholesterol and BP were noted to decrease but were not different between the two groups. However, body weight loss subjects tend to achieve ADA currently recommended goals of prevention CVD more than body weight gain subjects. These results suggest that diabetes patients with intention to complete the diabetes shared care model, whether body weight increase or decrease, were effective in blood glucose, lipid and pressure, with more from weight loss group than the weight gain group in achieving the ADA recommended goals. This study suggests that modest weight loss can have a long-time impact on prevention CVD risk.
