PDF(Pubmed)
Abstract：
UNASSIGNED: The objective of this Expert Consensus Statement is to assist clinicians in achieving remission of type 2 diabetes (T2D) in adults using diet as a primary intervention. Evidence-informed statements agreed upon by a multi-disciplinary panel of expert healthcare professionals were used.
UNASSIGNED: Panel members with expertise in diabetes treatment, research, and remission followed an established methodology for developing consensus statements using a modified Delphi process. A search strategist systematically reviewed the literature, and the best available evidence was used to compose statements regarding dietary interventions in adults 18 years and older diagnosed with T2D. Topics with significant practice variation and those that would result in remission of T2D were prioritized. Using an iterative, online process, panel members expressed levels of agreement with the statements, resulting in classification as consensus, near-consensus, or non-consensus based on mean responses and the number of outliers.
UNASSIGNED: The expert panel identified 131 candidate consensus statements that focused on addressing the following high-yield topics: (1) definitions and basic concepts; (2) diet and remission of T2D; (3) dietary specifics and types of diets; (4) adjuvant and alternative interventions; (5) support, monitoring, and adherence to therapy; (6) weight loss; and (7) payment and policy. After 4 iterations of the Delphi survey and removal of duplicative statements, 69 statements met the criteria for consensus, 5 were designated as near consensus, and 60 were designated as no consensus. In addition, the consensus was reached on the following key issues: (a) Remission of T2D should be defined as HbA1c <6.5% for at least 3 months with no surgery, devices, or active pharmacologic therapy for the specific purpose of lowering blood glucose; (b) diet as a primary intervention for T2D can achieve remission in many adults with T2D and is related to the intensity of the intervention; and (c) diet as a primary intervention for T2D is most effective in achieving remission when emphasizing whole, plant-based foods with minimal consumption of meat and other animal products. Many additional statements that achieved consensus are highlighted in a tabular presentation in the manuscript and elaborated upon in the discussion section.
UNASSIGNED: Expert consensus was achieved for 69 statements pertaining to diet and remission of T2D, dietary specifics and types of diets, adjuvant and alternative interventions, support, monitoring, adherence to therapy, weight loss, and payment and policy. Clinicians can use these statements to improve quality of care, inform policy and protocols, and identify areas of uncertainty.
UNASSIGNED: Panel members with expertise in diabetes treatment, research, and remission followed an established methodology for developing consensus statements using a modified Delphi process. A search strategist systematically reviewed the literature, and the best available evidence was used to compose statements regarding dietary interventions in adults 18 years and older diagnosed with T2D. Topics with significant practice variation and those that would result in remission of T2D were prioritized. Using an iterative, online process, panel members expressed levels of agreement with the statements, resulting in classification as consensus, near-consensus, or non-consensus based on mean responses and the number of outliers.
UNASSIGNED: The expert panel identified 131 candidate consensus statements that focused on addressing the following high-yield topics: (1) definitions and basic concepts; (2) diet and remission of T2D; (3) dietary specifics and types of diets; (4) adjuvant and alternative interventions; (5) support, monitoring, and adherence to therapy; (6) weight loss; and (7) payment and policy. After 4 iterations of the Delphi survey and removal of duplicative statements, 69 statements met the criteria for consensus, 5 were designated as near consensus, and 60 were designated as no consensus. In addition, the consensus was reached on the following key issues: (a) Remission of T2D should be defined as HbA1c <6.5% for at least 3 months with no surgery, devices, or active pharmacologic therapy for the specific purpose of lowering blood glucose; (b) diet as a primary intervention for T2D can achieve remission in many adults with T2D and is related to the intensity of the intervention; and (c) diet as a primary intervention for T2D is most effective in achieving remission when emphasizing whole, plant-based foods with minimal consumption of meat and other animal products. Many additional statements that achieved consensus are highlighted in a tabular presentation in the manuscript and elaborated upon in the discussion section.
UNASSIGNED: Expert consensus was achieved for 69 statements pertaining to diet and remission of T2D, dietary specifics and types of diets, adjuvant and alternative interventions, support, monitoring, adherence to therapy, weight loss, and payment and policy. Clinicians can use these statements to improve quality of care, inform policy and protocols, and identify areas of uncertainty.
摘要：
■本专家共识声明的目的是帮助临床医生使用饮食作为主要干预措施来缓解成人2型糖尿病（T2D）。使用了由多学科专家医疗保健专业人员组成的多学科小组同意的循证陈述。
■具有糖尿病治疗专业知识的小组成员，研究,和缓解遵循既定的方法，使用改进的德尔菲程序制定共识声明。一位搜索战略家系统地回顾了文献，在18岁及以上被诊断为T2D的成年人中,利用现有的最佳证据撰写了关于饮食干预的陈述.具有重大实践差异的主题以及将导致T2D缓解的主题被优先考虑。使用迭代，在线过程，小组成员对声明表示同意，导致分类为共识，接近共识,或基于平均响应和异常值数量的非共识。
■专家小组确定了131项候选共识声明，重点解决以下高产主题：（1）定义和基本概念；（2）T2D的饮食和缓解；（3）饮食细节和饮食类型；（4）辅助和替代干预措施；（5）支持，监测,和坚持治疗；（6）体重减轻；（7）付款和政策。在德尔菲调查的4次迭代和重复语句的删除之后，69项声明符合共识标准，5被指定为接近共识，60人被指定为无共识。此外,在以下关键问题上达成共识：（a）T2D缓解应定义为HbA1c<6.5％，持续至少3个月，不进行手术，设备,或以降低血糖为特定目的的积极药物治疗；（b）饮食作为T2D的主要干预措施可以在许多T2D成人中实现缓解，并且与干预的强度有关；（c）饮食作为T2D的主要干预措施在强调整体时最有效地实现缓解，以植物为基础的食物，最少消费肉类和其他动物产品。手稿的表格中突出了许多达成共识的其他陈述，并在讨论部分对此进行了阐述。
■就69项关于T2D饮食和缓解的声明达成了专家共识，饮食细节和饮食类型，辅助和替代干预措施，支持,监测,坚持治疗，减肥,以及付款和政策。临床医生可以使用这些声明来提高护理质量，告知政策和协议，并确定不确定的领域。
■具有糖尿病治疗专业知识的小组成员，研究,和缓解遵循既定的方法，使用改进的德尔菲程序制定共识声明。一位搜索战略家系统地回顾了文献，在18岁及以上被诊断为T2D的成年人中,利用现有的最佳证据撰写了关于饮食干预的陈述.具有重大实践差异的主题以及将导致T2D缓解的主题被优先考虑。使用迭代，在线过程，小组成员对声明表示同意，导致分类为共识，接近共识,或基于平均响应和异常值数量的非共识。
■专家小组确定了131项候选共识声明，重点解决以下高产主题：（1）定义和基本概念；（2）T2D的饮食和缓解；（3）饮食细节和饮食类型；（4）辅助和替代干预措施；（5）支持，监测,和坚持治疗；（6）体重减轻；（7）付款和政策。在德尔菲调查的4次迭代和重复语句的删除之后，69项声明符合共识标准，5被指定为接近共识，60人被指定为无共识。此外,在以下关键问题上达成共识：（a）T2D缓解应定义为HbA1c<6.5％，持续至少3个月，不进行手术，设备,或以降低血糖为特定目的的积极药物治疗；（b）饮食作为T2D的主要干预措施可以在许多T2D成人中实现缓解，并且与干预的强度有关；（c）饮食作为T2D的主要干预措施在强调整体时最有效地实现缓解，以植物为基础的食物，最少消费肉类和其他动物产品。手稿的表格中突出了许多达成共识的其他陈述，并在讨论部分对此进行了阐述。
■就69项关于T2D饮食和缓解的声明达成了专家共识，饮食细节和饮食类型，辅助和替代干预措施，支持,监测,坚持治疗，减肥,以及付款和政策。临床医生可以使用这些声明来提高护理质量，告知政策和协议，并确定不确定的领域。
