今天是世界糖尿病日，今年以主题为中心healthy living and diabetes. To mark this, we take a look at some of the recent research and discussions on risk factors and lifestyle interventions associated with type 2 diabetes*.

Therise in the global burden of diabetesis expected to challenge healthcare systems. Already, it is estimated that29.1 million people在美国有条件。糖尿病是四个main non-communicable diseases and the World Health Organization (WHO) action plan includes a global strategy for its prevention and control. This is an important aim, as diabetes is known to lead to many co-morbid conditions, which in turn leads to significant burden on health and healthcare systems.

为了实现其目标，有必要针对糖尿病的危险因素并促进健康的生活方式。识别patients at riskfor diabetes involves recognising the signs and symptoms and this has been highlighted in recent research.

风险因素

有几个因素that increase risk of developing diabetes including fat distribution, excess weight, physical inactivity and family history. In anopinion文章发表在BMC医学纳维德·萨塔尔（Naveed Sattar）和杰森·吉尔（Jason Gill）讨论脂肪分布,表明肥胖is a major risk factor for diabetes by reviewing current evidence on theecotopic fathypothesis for the disease.

They suggest that insulin-resistance and beta-cell dysfunction can potentially be reversed if ectopic fat around the liver and pancreas is removed by surgery or diet. The authors emphasise that:

“现在的挑战是利用这种观察结果并转化为临床改进。开发这种临床翻译需要进行大量持续的工作，鉴于全球2型糖尿病的水平不断提高至关重要，鉴于全球肥胖症的持续增长，这将进一步上升。”

与脂肪有关，体重是糖尿病和体重和腰围的增加与糖尿病的发生率显着相关。这项研究还表明，腰围的增加似乎是糖尿病进展的危险因素，而不是体重增加。有趣的是，腰围通常由个体测量，这些值由self-measurement, are higher than those measured objectively. This suggests that overestimation should be taken into account when using self-measured waist circumference as a marker of abdominal adiposity and risk of diabetes.

其他较少知道的风险因素也正在探索。最近systematic review and meta-analysisshowed that if an individual’s spouse has a history of diabetes, this is associated with an increase of 26% in their own diabetes risk, suggesting that recognition of the shared socio-environmental factors mediating such risk could improve diabetes detection.

生活方式干预

Changes to our lifestyles are known to affect health outcomes, and physical activity is of key importance in managing diabetes. Devices such as pedometers or accelerometers have become increasingly popular over the years, with the aim of helping users to adhere to healthier lifestyles. A recent随机对照试验的荟萃分析indicates that step counters can indeed be useful , as these are associated with an increase in physical activity in patients with diabetes. However, further research is needed to assess whether these devices can lead to improvements in glycemic control.

在低至中收入的国家中，解决糖尿病患者的生活方式行为也是必不可少的。在拉丁美洲国家，如墨西哥，阿根廷，智利和巴西医疗保健系统正在努力应对诸如糖尿病等慢性疾病。

Armando Arredondo from the National Institute of Public Health in Mexico highlights the need for more resources to be allocated to preventive medicine, and讨论在这些环境中可以实现这一目标的方法，说：

“In the context of ongoing reforms in the health systems of Latin American countries, and taking into account the state of the art of medicine, universal coverage for health care will be effective only if it meets the health needs in all phases of the natural history of disease: prevention, detection, treatment and rehabilitation, particularly in the case of chronic health problems.”

The research we look at here is part of a bigger trend showing the importance of targeting key risk factors to help reverse or improve detection of diabetes. It is essential to focus on healthy lifestyle behaviors including physical activity to enable effective management of the illness. However, this is going to be a challenge in low and middle income countries where resources are limited and thus more difficult to implement in health systems.

The WHO action plan aims to promote partnerships for the prevention and control of diabetes and to integrate these into policies across government departments. Hopefully this will shape global strategies to ultimately reduce the burden of this serious non-communicable disease.

*由于我们仅关注2型糖尿病，因此我们使用糖尿病一词来指代它。

You can find research and related content about World Diabetes Day from both BioMed Central and Springer athttps://www.springer.com/diabetesday

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2013年中位数流动时间：初始决定三天；同行评审后的决定51天