Diet, Diabetic

饮食,糖尿病
  • 文章类型: Journal Article
    这项研究旨在确定2型糖尿病患者是否可以从基于糖尿病管理指南设计的膳食计划中受益,以改善血糖水平。将参与者分为干预组和对照组。干预组服用糖尿病饮食2周,而对照组消耗正常饮食。2周后,这些小组改变了他们的饮食方案.评估参与者的人口统计学和临床特征,包括血压等因素,血脂水平,体重和腰围,血糖水平(自我监测和连续监测),营养状况,和基于血液的营养素摄入量标记。饮食干预组改善腰围,身体脂肪百分比,低密度脂蛋白胆固醇,甘油三酯水平,和葡萄糖。碳水化合物和蛋白质的能量组成比例发生了良好的变化,糖摄入量减少。此外,干预组的连续血糖监测读数在180~250mg/dL范围内的比例相对低于对照组.根据糖尿病管理指南设计的膳食可以改善临床因素,包括日常生活中稳定的血糖水平,显着降低碳水化合物的能量比,并增加蛋白质能量比。这项研究可以帮助确定饮食干预在糖尿病管理和结果中的作用。
    This study aimed to determine whether patients with type 2 diabetes can benefit from a meal plan designed based on diabetes management guidelines to improve blood glucose levels. Participants were divided into intervention and control groups. The intervention group consumed a diabetic diet for 2 weeks, while the control group consumed their normal diet. After 2 weeks, the groups switched their dietary regimens. The participants\' demographic and clinical characteristics were evaluated, including factors such as blood pressure, blood lipid levels, weight and waist circumference, blood glucose levels (self-monitored and continuously monitored), nutritional status, and blood-based markers of nutrient intake. The dietary intervention group improved waist circumference, body fat percentage, low-density lipoprotein cholesterol, triglyceride levels, and glucose. The energy composition ratio of carbohydrates and proteins changed favorably, and sugar intake decreased. In addition, the proportion of continuous glucose monitoring readings within the range of 180-250 mg/dL was relatively lower in the intervention group than that of the control group. Meals designed based on diabetes management guidelines can improve clinical factors, including stable blood glucose levels in daily life, significantly decrease the carbohydrate energy ratio, and increase the protein energy ratio. This study can help determine the role of dietary interventions in diabetes management and outcomes.
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  • 文章类型: Randomized Controlled Trial
    高糖消耗会增加患糖尿病的风险,肥胖,和心血管疾病。关于糖尿病患者的饮食,人造甜味剂被认为是糖的安全替代品;然而,人造甜味剂也有加剧葡萄糖代谢的风险。D-阿洛酮糖(D-果糖的C-3异构体),这是一种稀有的糖,据报道具有抗糖尿病和抗肥胖作用。在这项研究中,本研究使用间歇性扫描连续血糖监测系统(isCGM)研究了含有D-阿洛酮糖的糖尿病饮食在2型糖尿病患者中的疗效.这项研究是经过验证的,prospective,单盲,随机化,交叉比较研究。消耗标准糖尿病饮食和含有8.5gD-阿洛酮糖的糖尿病饮食后的餐后血糖(PPG)峰值水平的比较是主要终点。与严格控制能量的糖尿病饮食相比,含D-阿洛酮糖的糖尿病饮食改善了2型糖尿病患者的PPG水平。结果还显示,由于胰岛素需求量减少,对内源性胰腺胰岛素分泌能力具有保护作用。在2型糖尿病患者中,含8.5gD-阿洛酮糖的糖尿病饮食可有效改善PPG水平.
    High sugar consumption increases the risk of diabetes, obesity, and cardiovascular diseases. Regarding the diet of patients with diabetes, artificial sweeteners are considered a safe alternative to sugar; however, there is also a risk that artificial sweeteners exacerbate glucose metabolism. D-allulose (C-3 isomer of d-fructose), which is a rare sugar, has been reported to have antidiabetic and antiobesity effects. In this study, the efficacy of a diabetic diet containing D-allulose was investigated in patients with type 2 diabetes using an intermittently scanned continuous glucose monitoring system (isCGM). This study was a validated, prospective, single-blind, randomized, crossover comparative study. Comparison of peak postprandial blood glucose (PPG) levels after consumption of a standard diabetic diet and a diabetic diet containing 8.5 g of D-allulose was the primary endpoint. A D-allulose-containing diabetic diet improved PPG levels in type two diabetes patients compared with a strictly energy-controlled diabetic diet. The results also showed a protective effect on endogenous pancreatic insulin secretory capacity owing to reduced insulin requirement. In patients with type two diabetes mellitus, diabetic diets containing 8.5 g D-allulose were effective in improving PPG levels.
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  • 文章类型: Journal Article
    饮食摄入建议是妊娠期糖尿病(GDM)管理的重要一线干预措施。已经提出了基于网络和智能手机应用程序等数字工具,以提供一种新颖的方式来提供饮食信息,以实现GDM女性的最佳血糖调节。本系统综述探讨了旨在支持GDM饮食自我管理的数字工具的有效性和可用性。对Medline的系统搜索,Embase,护理和相关健康文献累积指数(CINAHL),科克伦图书馆,Scopus使用关键搜索词确定了1476篇报告研究的论文,其中16人符合规定的纳入标准。使用ErasmusAGE质量评分或2018年混合方法评估工具(MMAT)版本评估纳入研究的质量。研究结果表明,采用数字工具可能是支持与健康饮食相关的自我管理的有效方法,健康行为,GDM女性坚持治疗作为一种有效的干预措施。然而,缺乏支持GDM饮食管理的工具有效性的证据.在开发有效的GDM饮食管理数字工具时,应考虑种族特定的饮食建议和基于证据的框架,因为这些方面在所审查的研究中受到限制。
    Advice on dietary intake is an essential first line intervention for the management of gestational diabetes mellitus (GDM). Digital tools such as web-based and smartphone apps have been suggested to provide a novel way of providing information on diet for optimal glucose regulation in women with GDM. This systematic review explores the effectiveness and usability of digital tools designed to support dietary self-management of GDM. A systematic search of Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, and Scopus using key search terms identified 1476 papers reporting research studies, of which 16 met the specified inclusion criteria. The quality of the included studies was assessed using the ErasmusAGE Quality Score or the Mixed Methods Appraisal Tool (MMAT) version 2018. The findings show that the adoption of digital tools may be an effective approach to support self-management relating to healthy diet, health behaviour, and adherence to therapy in women with GDM as a usable intervention. However, there is a lack of evidence concerning the effectiveness of tools to support the dietary management of GDM. Consideration for ethnic specific dietary advice and evidence-based frameworks in the development of effective digital tools for dietary management of GDM should be considered as these aspects have been limited in the studies reviewed.
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  • 文章类型: Journal Article
    营养对于维持正常生长至关重要,发展,和年轻人糖尿病患者的血糖控制(PwD)。过度的限制会导致营养缺乏以及对膳食计划的依从性差。低成本的广泛可用性,超加工,和美味的食物进一步损害。大多数家庭都在努力寻找提供营养的方法,但很有吸引力,低血糖指数(GI)的食物。印度是最古老的连续文明之一,拥有丰富多样的文化和烹饪遗产。传统的饮食习惯,包括数百年历史的“Thali”(意思是盘子)概念,强调组合(谷物,扁豆,蔬菜,乳制品,香料,益生元和益生菌,和脂肪)的地方,季节性,主要是植物性成分。这些做法确保提供所有必要的食物组,并符合当前基于证据的建议,包括国际小儿和青少年糖尿病学会(ISPAD)2018年指南。制备技术,烹饪,和食物的保存进一步影响GI和营养素的可用性。这些做法有利于营养密度,饮食多样性,和适口性,从而提高对膳食计划和血糖控制的依从性。这篇叙事评论描述了古老的智慧,食物成分,以及来自印度各地的烹饪实践,这些实践在今天仍然很有价值。这些可能在全球范围内有益于改善血糖控制和生活质量。尤其是在PwD。
    Nutrition is crucial for maintaining normal growth, development, and glycemic control in young people with diabetes (PwD). Undue restrictions cause nutrient deficiencies as well as poor adherence to meal plans. Widespread availability of low-cost, ultra-processed, and hyperpalatable food is further damaging. Most families struggle to find ways to provide nutritious, yet attractive, food with a low glycemic index (GI). India is one of the oldest continuous civilizations with a rich and diverse cultural and culinary heritage. Traditional dietary practices, including the centuries-old \'Thali\' (meaning plate) concept, emphasize combinations (grains, lentils, vegetables, dairy, spices, prebiotics and probiotics, and fats) of local, seasonal, and predominantly plant-based ingredients. These practices ensure that all of the necessary food groups are provided and fit well with current evidence-based recommendations, including the International Society for Pediatric and Adolescent Diabetes (ISPAD) 2018 Guidelines. Techniques for the preparation, cooking, and preservation of food further impact the GI and nutrient availability. These practices benefit nutrient density, diet diversity, and palatability and thus improve adherence to meal plans and glycemic control. This narrative review describes the ancient wisdom, food composition, and culinary practices from across India which are still valuable today. These may be of benefit worldwide to improve glycemic control as well as quality of life, especially in PwD.
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  • 文章类型: Journal Article
    Unhealthy behaviours, including diet and physical activity, coupled with genetic predisposition, drive type 2 diabetes (T2D) occurrence and severity; the present review aims to summarise the most recent nutritional approaches in T2D, outlining unmet needs. Guidelines consistently suggest reducing energy intake to counteract the obesity epidemic, frequently resulting in sarcopenic obesity, a condition associated with poorer metabolic control and cardiovascular disease. Various dietary approaches have been proposed with largely similar results, with a preference for the Mediterranean diet and the best practice being the diet that patients feel confident of maintaining in the long term based on individual preferences. Patient adherence is indeed the pivotal factor for weight loss and long-term maintenance, requiring intensive lifestyle intervention. The consumption of nutritional supplements continues to increase even if international societies do not support their systematic use. Inositols and vitamin D supplementation, as well as micronutrients (zinc, chromium, magnesium) and pre/probiotics, result in modest improvement in insulin sensitivity, but their use is not systematically suggested. To reach the desired goals, patients should be actively involved in the collaborative development of a personalised meal plan associated with habitual physical activity, aiming at normal body weight and metabolic control.
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  • 文章类型: Journal Article
    背景:2型糖尿病(T2D)可以通过饮食和生活方式的改变来管理。美国糖尿病协会承认,知道什么和什么时候吃是糖尿病管理中最具挑战性的方面。尽管目前关于饮食和血糖水平自我监测的建议旨在改善T2D患者的血糖稳定性,跟踪所有摄入量是繁重和不可持续的。因此,应该探索同样有效但负担较小的饮食自我监测方法。
    目的:本研究旨在研究简化饮食自我监测方法在T2D患者中的可行性,其中只有含碳水化合物的食物被记录在饮食跟踪器中。
    方法:我们使用混合方法方法定量和定性评估了30名患有T2D的男性和女性的一般和饮食相关糖尿病知识以及仅报告含碳水化合物食物的可接受性。
    结果:糖尿病知识测验平均得分为83.9%(SD14.2%)。只有20%(6/30)的参与者正确地将5种常用的含碳水化合物的食物和5种非碳水化合物的食物分类。在10分制下,仅报告含碳水化合物的食物的平均感知难度为5.3。大约一半的参与者(16/30,53%)更愿意记录所有食物。缺乏关于含碳水化合物食物的知识是被引用的可接受性的主要障碍(12/30,40%)。
    结论:仅报告含碳水化合物食物的简化饮食自我监测可能不可行,因为碳水化合物特异性知识有限,并且大多数参与者倾向于报告所有食物。其他不依赖于食物特异性知识的减少T2D患者饮食自我监测负担的方法可能更可行。
    BACKGROUND: Type 2 diabetes mellitus (T2D) can be managed through diet and lifestyle changes. The American Diabetes Association acknowledges that knowing what and when to eat is the most challenging aspect of diabetes management. Although current recommendations for self-monitoring of diet and glucose levels aim to improve glycemic stability among people with T2D, tracking all intake is burdensome and unsustainable. Thus, dietary self-monitoring approaches that are equally effective but are less burdensome should be explored.
    OBJECTIVE: This study aims to examine the feasibility of an abbreviated dietary self-monitoring approach in patients with T2D, in which only carbohydrate-containing foods are recorded in a diet tracker.
    METHODS: We used a mixed methods approach to quantitatively and qualitatively assess general and diet-related diabetes knowledge and the acceptability of reporting only carbohydrate-containing foods in 30 men and women with T2D.
    RESULTS: The mean Diabetes Knowledge Test score was 83.9% (SD 14.2%). Only 20% (6/30) of participants correctly categorized 5 commonly consumed carbohydrate-containing foods and 5 noncarbohydrate-containing foods. The mean perceived difficulty of reporting only carbohydrate-containing foods was 5.3 on a 10-point scale. Approximately half of the participants (16/30, 53%) preferred to record all foods. A lack of knowledge about carbohydrate-containing foods was the primary cited barrier to acceptability (12/30, 40%).
    CONCLUSIONS: Abbreviated dietary self-monitoring in which only carbohydrate-containing foods are reported is likely not feasible because of limited carbohydrate-specific knowledge and a preference of most participants to report all foods. Other approaches to reduce the burden of dietary self-monitoring for people with T2D that do not rely on food-specific knowledge could be more feasible.
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  • 文章类型: Journal Article
    2型糖尿病(T2D)的患病率正在增加,造成了巨大的经济负担。饮食是治疗和管理T2D的关键因素;然而,有大量的饮食方法,并且对于每种方法的功效普遍缺乏共识。因此,这篇叙述性综述的目的是双重的:(1)批判性地评估各种饮食策略对糖尿病管理和治疗的影响,比如地中海饮食,植物性饮食,低热量和非常低热量的饮食,间歇性禁食,低碳水化合物和极低碳水化合物饮食,和低血糖饮食和(2)检查几种所谓的补充剂,如蛋白质,支链氨基酸,肌酸,和维生素D改善血糖控制和身体成分。这篇评论可以作为那些想要评估支持可能有助于管理T2D的各种饮食策略和补充剂的证据的人的资源。
    The prevalence of Type 2 diabetes (T2D) is increasing, which creates a large economic burden. Diet is a critical factor in the treatment and management of T2D; however, there are a large number of dietary approaches and a general lack of consensus regarding the efficacy of each. Therefore, the purpose of this narrative review is twofold: (1) to critically evaluate the effects of various dietary strategies on diabetes management and treatment, such as Mediterranean diet, plant-based diet, low-calorie and very low-calorie diets, intermittent fasting, low-carbohydrate and very low-carbohydrate diets, and low glycemic diets and (2) to examine several purported supplements, such as protein, branched-chain amino acids, creatine, and vitamin D to improve glucose control and body composition. This review can serve as a resource for those wanting to evaluate the evidence supporting the various dietary strategies and supplements that may help manage T2D.
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  • 文章类型: Journal Article
    通知欧洲糖尿病研究协会营养治疗临床实践指南的更新。
    随机对照试验的系统评价和荟萃分析。
    Medline,Embase,Cochrane图书馆搜索了2021年5月13日。
    为期三周或更长时间的随机对照试验,研究低血糖指数(GI)/血糖负荷(GL)饮食对糖尿病的影响。
    主要结果是糖化血红蛋白(HbA1c)。次要结果包括其他血糖控制指标(空腹血糖,空腹胰岛素);血脂(低密度脂蛋白胆固醇(LDL-C);高密度脂蛋白胆固醇(HDL-C),非HDL-C,apoB,甘油三酯);肥胖(体重,BMI(体重指数),腰围),血压(收缩压(SBP)和舒张压(DBP)),和炎症(C反应蛋白(CRP))。
    两名独立评审员提取数据并评估偏倚风险。数据通过随机效应模型汇集。等级(建议评估的等级,发展,和评估)用于评估证据的确定性。
    在1617名1型和2型糖尿病患者中进行了29项试验比较,这些患者主要是中年人,超重,或通过高血糖药物或胰岛素治疗的中度控制的2型糖尿病肥胖。与高GI/GL对照饮食相比,低GI/GL饮食模式降低了HbA1c(平均差异-0.31%(95%置信区间-0.42至-0.19%),P<0.001;实质性异质性,I2=75%,P<0.001)。空腹血糖也减少,LDL-C,非HDL-C,apoB,甘油三酯,体重,BMI,收缩压(剂量反应),和CRP(P<0.05),但不是血液胰岛素,HDL-C,腰围,或者舒张压.对于GL和HbA1c的差异以及绝对饮食GI和SBP,观察到正剂量反应梯度(P<0.05)。HbA1c降低的证据确定性较高,大多数次要结局的证据确定性较高,降级主要是由于不精确。
    这一合成表明,低GI/GL饮食模式导致血糖控制目标的小的重要改善,血脂,肥胖,血压,除了高血糖药物或胰岛素同时治疗之外的炎症,主要在中度控制的1型和2型糖尿病的成年人中。现有证据很好地表明了这一人群可能的益处。
    ClinicalTrials.govNCT04045938。
    To inform the update of the European Association for the Study of Diabetes clinical practice guidelines for nutrition therapy.
    Systematic review and meta-analysis of randomised controlled trials.
    Medline, Embase, and the Cochrane Library searched up to 13 May 2021.
    Randomised controlled trials of three or more weeks investigating the effect of diets with low glycaemic index (GI)/glycaemic load (GL) in diabetes.
    The primary outcome was glycated haemoglobin (HbA1c). Secondary outcomes included other markers of glycaemic control (fasting glucose, fasting insulin); blood lipids (low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), non-HDL-C, apo B, triglycerides); adiposity (body weight, BMI (body mass index), waist circumference), blood pressure (systolic blood pressure (SBP) and diastolic blood pressure (DBP)), and inflammation (C reactive protein (CRP)).
    Two independent reviewers extracted data and assessed risk of bias. Data were pooled by random effects models. GRADE (grading of recommendations assessment, development, and evaluation) was used to assess the certainty of evidence.
    29 trial comparisons were identified in 1617 participants with type 1 and 2 diabetes who were predominantly middle aged, overweight, or obese with moderately controlled type 2 diabetes treated by hyperglycaemia drugs or insulin. Low GI/GL dietary patterns reduced HbA1c in comparison with higher GI/GL control diets (mean difference −0.31% (95% confidence interval −0.42 to −0.19%), P<0.001; substantial heterogeneity, I2=75%, P<0.001). Reductions occurred also in fasting glucose, LDL-C, non-HDL-C, apo B, triglycerides, body weight, BMI, systolic blood pressure (dose-response), and CRP (P<0.05), but not blood insulin, HDL-C, waist circumference, or diastolic blood pressure. A positive dose-response gradient was seen for the difference in GL and HbA1c and for absolute dietary GI and SBP (P<0.05). The certainty of evidence was high for the reduction in HbA1c and moderate for most secondary outcomes, with downgrades due mainly to imprecision.
    This synthesis suggests that low GI/GL dietary patterns result in small important improvements in established targets of glycaemic control, blood lipids, adiposity, blood pressure, and inflammation beyond concurrent treatment with hyperglycaemia drugs or insulin, predominantly in adults with moderately controlled type 1 and type 2 diabetes. The available evidence provides a good indication of the likely benefit in this population.
    ClinicalTrials.gov NCT04045938.
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  • DOI:
    文章类型: Journal Article
    目的:研究荞麦-燕麦-豌豆(BOP)复合粉[荞麦∶燕麦∶豌豆=6∶1∶1(质量比)]对糖尿病大鼠血糖的影响。
    方法:在本研究中,将64只雄性SD大鼠按空腹血糖(FBG)和体重分为8组:正常对照组,模型对照组,二甲双胍组,荞麦组,燕麦组,BOP低剂量组(BOP-L),中剂量组(BOP-M),高剂量组(BOP-H)。正常对照组大鼠饲喂正常饮食,模型对照组和二甲双胍组给予高脂饮食(HFD),荞麦组的老鼠,燕麦组,和BOP-L,BOP-M,BOP-H组用含10%荞麦粉的HFD喂养,10%燕麦粉,3.3%防喷器,10%防喷器,30%防喷器,分别。所有组中的HFD具有相同百分比的来自脂肪的能量(45%)。30天后,喂食HFD的大鼠腹腔注射链脲佐菌素(30mg/kg,每周一次,持续两周)以建立糖尿病。模型建立成功后,再给大鼠喂食28天。在研究期间,体重,食物摄入量/体重(FI/BW)和水摄入量/体重(WI/BW),食品利用率,24h尿量,FBG,定期测定口服葡萄糖耐量试验的葡萄糖曲线下面积(GAUC)。在研究结束时,测定空腹血糖和胰岛素,并计算胰岛素抵抗的稳态模型评估(HOMA-IR)。
    结果:随着HFD和链脲佐菌素的诱导,与正常对照组相比,模型对照组大鼠有较高的FI/BW,WI/BW,24h尿量,FBG,GAUC,HOMA-IR(P<0.05),和较低的体重,食品利用率(P<0.05)。与模型对照组比较,三个防喷器组的大鼠体重均较高,食品利用率(P<0.05),和较低的WI/BW,HOMA-IR(P<0.05);BOP-L组和BOP-M组大鼠的FI/BW较低,24h尿量,FBG(P<0.05),BOP-M组大鼠的GAUC也较低(P<0.05)。糖尿病成立后,3个BOP组大鼠血糖等指标与荞麦组、燕麦组比较差异均无统计学意义(P>0.05)。
    结论:BOP有降低血糖的作用,糖尿病大鼠的胰岛素抵抗和糖尿病症状,具有进一步开发利用的价值。
    OBJECTIVE: To study the effects of buckwheat-oat-pea (BOP) composite flour [buckwheat ∶ oats ∶ peas=6 ∶ 1 ∶ 1 (quality ratio)] on blood glucose in diabetic rats.
    METHODS: In this study, 64 male Sprague-Dawley rats were divided into 8 groups by fasting blood glucose (FBG) and body weight: normal control group, model control group, metformin group, buckwheat group, oats group, BOP low-dose group (BOP-L), medium-dose group (BOP-M), and high-dose group (BOP-H). The rats in the normal control group were fed with normal diet, the rats in the model control group and metformin group were fed with a high-fat diet (HFD), and the rats in the buckwheat group, oats group, and BOP-L, BOP-M, BOP-H groups were fed with HFD containing 10% buckwheat flour, 10% oat flour, 3.3% BOP, 10% BOP, 30% BOP, respectively. The HFD in all the groups had the same percentage of energy from fat (45%). After 30 days, the rats fed with HFD received intraperitoneal injection of streptozotocin (30 mg/kg, once a week for two weeks) to establish diabetes mellitus. After the model was successful established, the rats were fed for another 28 days. During the study, the body weight, food intake/body weight (FI/BW) and water intake/body weight (WI/BW), food utilization rate, 24 h urine volume, FBG, glucose area under curve (GAUC) of oral glucose tolerance test were measured regularly. At the end of the study, the fasting serum glucose and insulin were measured, and homeostasis model assessment of insulin resistance (HOMA-IR) was calculated.
    RESULTS: With the inducing of HFD and streptozotocin, compared with the normal control group, the rats in the model control group had higher FI/BW, WI/BW, 24 h urine volume, FBG, GAUC, HOMA-IR (P < 0.05), and lower body weight, food utilization rate (P < 0.05). Compared with the model control group, the rats in the three BOP groups all had higher body weight, food utilization rate (P < 0.05), and lower WI/BW, HOMA-IR (P < 0.05); the rats in the BOP-L and BOP-M groups had lower FI/BW, 24 h urine volume, FBG (P < 0.05), and the rats in the BOP-M group also had lower GAUC (P < 0.05). After the establishment of diabetes, there was no significant difference in blood glucose and the other indicators between the rats in the three BOP groups and the buckwheat group or the oats group (P>0.05).
    CONCLUSIONS: The BOP had the effects of reducing blood glucose, insulin resistance and diabetic symptoms on diabetic rats, and had the value for further development and utilization.
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  • 文章类型: Editorial
    糖尿病的患病率在全球范围内呈上升趋势,是21世纪增长最快的国际卫生紧急情况之一[。..].
    The prevalence of diabetes is on the increase worldwide, being one of the fastest growing international health emergencies in the 21st century [...].
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