{"id":8842,"date":"2013-06-18T13:54:19","date_gmt":"2013-06-18T04:54:19","guid":{"rendered":"http:\/\/arita.com\/ar\/?p=8842"},"modified":"2016-12-29T09:44:36","modified_gmt":"2016-12-29T00:44:36","slug":"%e7%b3%96%e8%b3%aa%e5%88%b6%e9%99%90%e3%81%ae%e7%a7%91%e5%ad%a6%e7%9a%84%e6%a0%b9%e6%8b%a0%e3%83%bb%e3%83%bb%e3%83%bb%e7%b1%b3%e5%9b%bd%e7%b3%96%e5%b0%bf%e7%97%85%e5%ad%a6%e4%bc%9a%e3%81%ae%e8%a6%8b","status":"publish","type":"post","link":"https:\/\/arita.com\/ar\/?p=8842","title":{"rendered":"\u7cd6\u8cea\u5236\u9650\u306b\u306f\u79d1\u5b66\u7684\u6839\u62e0\u3042\u308a\u30fb\u30fb\u30fb\u7c73\u56fd\u7cd6\u5c3f\u75c5\u5354\u4f1a\u306e\u898b\u89e3\u3000\u305d\u306e\uff11"},"content":{"rendered":"

\"dbcare13\"<\/a>\u65e5\u672c\u306e\u7cd6\u5c3f\u75c5\u5b66\u4f1a\u304c\u7834\u7dbb\u3057\u3066\u3044\u308b\u3053\u3068\u306f\u65e2\u306b\u89e6\u308c\u305f\u901a\u308a\u3002\u5148\u65e5\u767a\u8868\u3055\u308c\u305f\u300c\u718a\u672c\u5ba3\u8a002013 \u3042\u306a\u305f\u3068\u3042\u306a\u305f\u306e\u5927\u5207\u306a\u4eba\u306e\u305f\u3081\u306b<\/a>\u300d\u3092\u307f\u308b\u3068\u3001\u3044\u307e\u3060\u306b\u60a3\u8005\u3055\u3093\u306b\u5b9f\u884c\u56f0\u96e3\u3067\u3001\u5408\u4f75\u75c7\u3092\u5f15\u304d\u8d77\u3053\u3057\u304b\u306d\u306a\u3044\u30ab\u30ed\u30ea\u30fc\u5236\u9650\u98df\u3092\u8ab2\u3057\u3066\u3044\u307e\u3059\u3002\u601d\u3046\u306b\u3001\u300c\u3042\u306a\u305f\u3068\u3042\u306a\u305f\u306e\u5927\u5207\u306a\u4eba\u306e\u305f\u3081\u306b\u300d\u3068\u3044\u3046\u306e\u306f\u60a3\u8005\u3055\u3093\u306e\u3053\u3068\u3067\u306f\u306a\u304f\u3001\u8cac\u4efb\u56de\u907f\u3092\u9858\u3046\u7cd6\u5c3f\u75c5\u533b\u3084\u6804\u990a\u58eb\u305d\u306e\u4ed6\u5229\u76ca\u95a2\u4fc2\u8005\u306e\u3053\u3068\u3092\u6307\u3057\u3066\u3044\u308b\u306e\u3067\u3057\u3087\u3046\u3002\u3053\u306e\u5ba3\u8a00\u306e\u554f\u984c\u70b9\u306b\u3064\u3044\u3066\u306f\u6c5f\u90e8\u5eb7\u4e8c\u533b\u5e2b\u304c\u92ed\u304f\u6307\u6458<\/a>\u3057\u3066\u3044\u308b\u306e\u3067\u3001\u305d\u3061\u3089\u3092\u3054\u53c2\u7167\u4e0b\u3055\u3044\u3002<\/p>\n

\u65e5\u672c\u7cd6\u5c3f\u75c5\u5b66\u4f1a\u304c\u306a\u305c\u30c0\u30e1\u306a\u306e\u304b\u3002\u307e\u305a\u7b2c\u4e00\u306b\u3001\u305d\u306e\u53d6\u308a\u7d44\u307f\u306b\u79d1\u5b66\u7684\u6839\u62e0\u3092\u8457\u3057\u304f\u6b20\u3044\u3066\u3044\u308b\u3053\u3068\u304c\u6319\u3052\u3089\u308c\u307e\u3059\u3002\u306a\u305c\u304b\u3002\u7c73\u56fd\u306e\u7cd6\u5c3f\u75c5\u5354\u4f1a(ADA American Diabetes Association\uff09\u306e\u52e7\u544a\u3092\u4f8b\u306b\u3068\u3063\u3066\u8003\u3048\u3066\u307f\u307e\u3057\u3087\u3046\u3002\u307e\u305a\u305d\u306e\uff11\u3067ADA\u52e7\u544a\u306e\u79d1\u5b66\u7684\u6839\u62e0\u3092\u7c21\u5358\u306b\u793a\u3057\u3001\u305d\u306e\uff12\u3067\u306f\u52e7\u544a\u306e\u5185\u5bb9\u3001\u5909\u9077\u3068\u73fe\u72b6\u3092\u307f\u3066\u3044\u304f\u3053\u3068\u306b\u3057\u307e\u3059\u3002\uff08\u4ee5\u524d\u3001ADA\u3092\u7c73\u56fd\u7cd6\u5c3f\u75c5\u5b66\u4f1a\u3068\u8868\u8a18\u3057\u3066\u3044\u307e\u3057\u305f\u304c\u3001\u65e5\u672c\u3067\u3044\u3046\u3068\u3053\u308d\u306e\u5b66\u4f1a\u3058\u3083\u306a\u3044\u306e\u3067\u7c73\u56fd\u7cd6\u5c3f\u75c5\u5354\u4f1a\u306b\u5909\u66f4\uff09\uff09<\/p>\n

<\/p>\n

\u30fb\u30fb\u30fb<\/p>\n

\u7c73\u56fd\u7cd6\u5c3f\u75c5\u5b66\u4f1a\uff08\u4ee5\u4e0b\u3001ADA\uff09\u306e\u57fa\u6e96\u52e7\u544a\u3001Standards of Medical Care in Diabetes \u3092\u8aac\u660e\u3059\u308b\u305f\u3081\u306b\u306f\u3001\u307e\u305aADA\u304c\u305d\u306e\u8ad6\u7406\u7684\u57fa\u76e4\u3092\u7f6e\u3044\u3066\u3044\u308bEBM\u306e\u8a71\u304b\u3089\u59cb\u3081\u308b\u5fc5\u8981\u304c\u3042\u308a\u307e\u3059\u3002<\/p>\n

\u73fe\u5728\u3001\u533b\u7642\u95a2\u4fc2\u8005\u306fEvidence-based medicine (EBM; \u79d1\u5b66\u7684\u6839\u62e0\u306b\u57fa\u3065\u304f\u533b\u5b66)\u3092\u9032\u3081\u3066\u3044\u307e\u3059\u3002\u306a\u305c\u3001\u79d1\u5b66\u7684\u6839\u62e0\u3092\u308f\u3056\u308f\u3056\u4e91\u3005\u3057\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044\u304b\u3068\u3044\u3046\u3068\u3001\u5947\u5999\u3067\u602a\u3057\u304f\u6839\u62e0\u306b\u57fa\u3065\u304b\u306a\u3044\u533b\u7642\u884c\u70ba\u304c\u4e16\u306e\u4e2d\u306b\u305f\u304f\u3055\u3093\u8513\u5ef6\u3063\u3066\u3044\u308b\u3053\u3068\u306e\u88cf\u8fd4\u3057\u3067\u3059\uff08\u6ce8\uff09\u3002<\/p>\n

\u305d\u306eEBM\u306b\u306f\u3044\u308d\u3044\u308d\u306a\u5b9a\u7fa9\u304c\u3042\u308a\u307e\u3059\u3002Wikipedia\u306b\u306f\u3044\u3064\u304f\u304b\u7d39\u4ecb\u3055\u308c\u3066\u3044\u307e\u3059<\/a>\u304c\u3001\u4e00\u822c\u7684\u306b\u306f\u79d1\u5b66\u7684\u6839\u62e0\u306e\u78ba\u304b\u3055\u3068\u30ea\u30b9\u30af\u3068\u306e\u517c\u306d\u5408\u3044\u306b\u3088\u3063\u3066\u3001A\u3001B\u3001C\u3001D\u2026\u3068\u5206\u985e\u3059\u308b\u306e\u304c\u901a\u4f8b\u3067\u3059\u3002<\/p>\n

\u6700\u5f37\u306eA\u306fRCT\uff08\u30e9\u30f3\u30c0\u30e0\u5316\u6bd4\u8f03\u8a66\u9a13\uff09\u306a\u3069\u3067\u78ba\u8a8d\u3055\u308c\u305f\u4e8b\u5b9f\u306b\u57fa\u3065\u304f\u3082\u306e\u3092\u6307\u3057\u3001\u3082\u3063\u3068\u3082\u79d1\u5b66\u7684\u6839\u62e0\u306e\u3042\u308b\u3082\u306e\u3067\u3059\u3002\u6b21\u70b9\u306eB\u306f\u30e9\u30f3\u30c0\u30e0\u5316\u3055\u308c\u3066\u3044\u306a\u3044\u8abf\u67fb\u3084\u30b3\u30db\u30fc\u30c8\u7814\u7a76\u7b49\u3092\u6271\u3063\u305f\u3082\u306e\u3067\u3001A\u3088\u308a\u5c11\u3057\u4fe1\u983c\u6027\u304c\u52a3\u308b\u3082\u306e\u3067\u3001C\u306f\u4fbf\u76ca\u306f\u3042\u308b\u304c\u30ea\u30b9\u30af\u304c\u62ee\u6297\u3057\u3066\u3044\u308b\u3082\u306e\u3001\u6700\u5f8c\u306eD\u306f\u30ea\u30b9\u30af\u304c\u4fbf\u76ca\u3088\u308a\u4e0a\u56de\u3063\u3066\u3044\u308b\u6839\u62e0\u304c\u3042\u308a\u3001\u7121\u75c7\u72b6\u306e\u8005\u306b\u306f\u85a6\u3081\u3089\u308c\u306a\u3044\u3068\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u3055\u3089\u306bUSPSTF\uff08\u7c73\u56fd\u4e88\u9632\u30b5\u30fc\u30d3\u30b9\u5c02\u9580\u59d4\u54e1\u4f1a\uff09\u3067\u306f\u3001\u30ec\u30d9\u30eb\u306eI\u30af\u30e9\u30b9\u3092\u8a2d\u3051\u3001\u6839\u62e0\u304c\u306a\u3044\u304b\u8ca7\u5f31\u3067\u30ea\u30b9\u30af\u4fbf\u76ca\u304c\u52d8\u5b9a\u3067\u304d\u306a\u3044\u3082\u306e\u3092\u5225\u5efa\u3066\u306b\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n

\u3055\u3066\u3001\u3053\u308c\u304b\u3089\u7c73\u56fd\u7cd6\u5c3f\u75c5\u5b66\u4f1a\uff08ADA\uff09\u306e\u52e7\u544a\u57fa\u6e96\u306e\u4e2d\u8eab\u306b\u5165\u3063\u3066\u3044\u304d\u307e\u3057\u3087\u3046\u3002ADA\u3067\u306f\u6bce\u5e741\u6708\u306b\u6a5f\u95a2\u8a8c\u306eDiabete Care \u3067\u3001\u305d\u306e\u5e74\u306e\u7cd6\u5c3f\u75c5\u306b\u5bfe\u3059\u308b\u533b\u7642\u57fa\u6e96\u3092\u767a\u8868<\/a>\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n

ADA\u306e\u7cd6\u5c3f\u75c5\u52e7\u544a\u3067\u306fA\u3001B\u3001C\u3001E\u306e4\u3064\u306e\u6839\u62e0\u6c34\u6e96\u304c\u307e\u305a\u793a\u3055\u308c\u3001\u52e7\u544a\u305d\u308c\u305e\u308c\u306b\u79d1\u5b66\u7684\u4fe1\u983c\u6027\u304c\u3069\u308c\u304f\u3089\u3044\u3042\u308b\u306e\u304b\u304c\u660e\u78ba\u306b\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u7d30\u304b\u3044\u8a71\u3092\u629c\u304d\u306b\u3059\u308b\u3068\u3001ADA\u306eA\u3001B\u3001C\u306f\u5148\u306b\u793a\u3057\u305fEBM\u306eA\u3001B\u3001C\u3068\u307b\u307c\u540c\u3058\u3082\u306e\u3002\u305f\u3060\u3001\u6700\u5f8c\u306eE\u306f\u5c02\u9580\u5bb6\u306e\u30b3\u30f3\u30bb\u30f3\u30b5\u30b9\u3042\u308b\u3044\u306f\u81e8\u5e8a\u7d4c\u9a13\uff08Expert consensus or clinical experience\uff09\u3068\u306a\u3063\u3066\u304a\u308a\u3001\u6839\u62e0\u304c\u306a\u304f\u3066\u3082\u30d7\u30ed\u304c\u4e91\u3046\u3093\u3060\u304b\u3089\u30aa\u30c3\u30b1\u30a4\u3060\u3001\u3068\u3044\u3046\u5909\u306a\u3082\u306e\u304c\u4ed8\u5c5e\u3057\u3066\u3044\u307e\u3059\uff08\u602a\u3057\u3052\u306a\u3082\u306e\u3092\u63a8\u5968\u3057\u3066\u304d\u305f\u904e\u53bb\u306e\u30de\u30a4\u30ca\u30b9\u907a\u7523\u306b\u5bfe\u3059\u308b\u9003\u3052\u306a\u306e\u304b\uff09\u3002<\/p>\n

\u554f\u984c\u306e\u7cd6\u8cea\u5236\u9650\u3067\u3059\u304c\u3001ADA\u52e7\u544a\u3067\u767b\u5834\u3057\u305f\u306e\u306f2008\u5e74\u306e\u3053\u3068\u3067\u3057\u305f\u3002\u305d\u308c\u4ee5\u524d\u3067\u306f\u3069\u3046\u3060\u3063\u305f\u304b\u3068\u3044\u3046\u3068\u3001\u305f\u3068\u3048\u30702007\u5e74\u52e7\u544a\u3067\u306f\u4ee5\u4e0b\u306e\u3088\u3046\u306b\u8a18\u8f09\u3055\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n

Low-carbohydrate diets (restricting total carbohydrate to <130 g\/day) are not recommended in the treatment of over- weight\/obesity. The long-term effects of these diets are unknown, and although such diets produce short-term weight loss, maintenance of weight loss is similar to that from low-fat diets and the impact on CVD risk profile is uncertain. (B) \uff08Executive Summary: Standards of Medical Care in Diabetes 2007\u3000\u3088\u308a\uff09<\/p><\/blockquote>\n

\u79c1\u8a33\u3059\u308b\u3068\u3001\u300c\u4f4e\u70ad\u6c34\u5316\u7269\u306e\u98df\u4e8b\uff081\u65e5130g\u4ee5\u4e0b\u306b\u5236\u9650\uff09\u306f\u80a5\u6e80\u306e\u6cbb\u7642\u3068\u3057\u3066\u85a6\u3081\u3089\u308c\u307e\u305b\u3093\u3002\u305d\u306e\u9577\u671f\u7684\u5f71\u97ff\u306f\u308f\u304b\u3063\u3066\u304a\u3089\u305a\u3001\u77ed\u671f\u7684\u306b\u306f\u4f53\u91cd\u6e1b\u5c11\u306b\u306a\u3063\u3066\u3082\u7ba1\u7406\u306f\u4f4e\u8102\u80aa\u98df\u306b\u3088\u308b\u3082\u306e\u3068\u540c\u7b49\u3001\u5fc3\u81d3\u8840\u7ba1\u7cfb\u75be\u75c5\u3078\u306e\u5f71\u97ff\u3082\u4e0d\u78ba\u304b\u3067\u3059\u3002(B)\u300d<\/p>\n

\u672b\u5c3e\u306e(B)\u306f\u79d1\u5b66\u7684\u6839\u62e0\u304cB\u30e9\u30f3\u30af\u3001\u3064\u307e\u308a\u660e\u5feb\u306a\u4e8b\u5b9f\u306b\u57fa\u3065\u304f\u898b\u89e3\u3067\u306f\u306a\u3044\u304c\u3001\u6700\u9ad8\u30e9\u30f3\u30af\u306eA\u3067\u306f\u306a\u3044\u3002\u3067\u3082\u3001\u6839\u62e0\u306e\u8584\u3044C\u30e9\u30f3\u30af\u4ee5\u4e0b\u3067\u306f\u306a\u3044\u3068\u3044\u3046\u610f\u5473\u5408\u3044\u306b\u306a\u3063\u3066\u3044\u307e\u3059\u3002<\/p>\n

\u3068\u3053\u308d\u304c\u30012008\u5e74\u306b\u306a\u308b\u3068\u3053\u306e\u8a18\u8ff0\u304c\u4ee5\u4e0b\u306e\u901a\u308a\u3001\u4e00\u65b0\u3057\u307e\u3059\u3002<\/p>\n

In overweight and obese insulin- resistant individuals, modest weight loss has been shown to reduce insulin resistance. Thus, weight loss is recommended for all overweight or obese in- dividuals who have or are at risk for diabetes. (A)<\/p>\n

For weight loss, either low-carbohy- drate or low-fat calorie-restricted diets may be effective in the short term (up to 1 year). (A) \uff08Executive Summary: Standards of Medical Care in Diabetes 2008\u3000\u3088\u308a\uff09<\/p><\/blockquote>\n

\u80a5\u6e80\u304c\u30a4\u30f3\u30b9\u30ea\u30f3\u306e\u62b5\u6297\u6027\u3092\u9ad8\u3081\u308b\u306e\u3067\u7cd6\u5c3f\u75c5\u60a3\u8005\u3084\u30e2\u30c9\u30ad\u4eba\u306b\u306f\u4f53\u91cd\u6e1b\u5c11\u304c\u63a8\u5968\u3055\u308c\u308b\u3002\u305d\u306e\u305f\u3081\u306b\u306f\u4f4e\u70ad\u6c34\u5316\u7269\u98df\uff08\u7cd6\u8cea\u5236\u9650\u98df\uff09\u3001\u4f4e\u8102\u80aa\u30ab\u30ed\u30ea\u30fc\u5236\u9650\u98df\u304c\u77ed\u671f\u7684\u306b\u52b9\u679c\u3042\u308a\u3001\u3068\u3055\u308c\u305f\u306e\u3067\u3059\u3002\u8981\u3059\u308b\u306b\u3001\u300c\u85a6\u3081\u3089\u308c\u306a\u3044\u7cd6\u8cea\u5236\u9650\u98df\u300d\u304c\u4e00\u8ee2\u3057\u3066\u300c\u52b9\u679c\u3042\u308a\u300d\u306b\u5909\u308f\u3063\u3066\u3057\u307e\u3044\u3001\u304a\u307e\u3051\u306b\u305d\u306e\u79d1\u5b66\u7684\u6839\u62e0\u306f\u6700\u9ad8\u30ec\u30d9\u30eb\u306eA\u3002\u3044\u3063\u305f\u30442007\u5e74\u304b\u30892008\u5e74\u306b\u81f3\u308b\u9593\u306b\u4f55\u304c\u3042\u3063\u305f\u306e\u3067\u3057\u3087\u3046\u304b\u3002<\/p>\n

\u7406\u7531\u306f\u3068\u3082\u304b\u304f\u30012008\u5e74\u4ee5\u964d\u7c73\u56fd\u7cd6\u5c3f\u75c5\u5b66\u4f1a\u306f\u7cd6\u8cea\u5236\u9650\u98df\uff08\u4f4e\u70ad\u6c34\u5316\u7269\u98df\uff09\u3092\u516c\u5f0f\u306b\u8a8d\u3081\u308b\u3053\u3068\u306b\u306a\u308a\u307e\u3057\u305f\u3002\u3053\u306e\u52e7\u544a\u306b\u3064\u3044\u3066\u3001\u3088\u308a\u8a73\u3057\u304f\u691c\u8a0e\u3057\u3066\u3044\u304f\u3053\u3068\u306b\u3057\u307e\u3057\u3087\u3046\uff08\u6b21\u56de\u3078\uff09\u3002
\n\"awabi13\"<\/p>\n

\uff08\u6ce8\uff09
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