We agree with Johnston and colleagues1that it is important to consider potential confounding factors, such as diet and exercise, when interpreting the results of our study.2 Our study did not include specific dietary counselling of patients, and there was no concerted effort to have patients adhere to a specific hypocaloric regimen. During follow-up visits, patients underwent per protocol (PP) dietary counselling based on standard clinical practice guidelines. These guidelines emphasise the relation of carbohydrate intake, glycaemic index and blood glucose control. Taking into account that patients willing to participate in a study are generally more motivated to make behavioural changes, it is possible that the subjects in …

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对题为“十二指肠黏膜表面置换后 2 型糖尿病患者 HbA1c 降低：是否有其他因素在起作用？”的回复

我们同意 Johnston 及其同事 1 的观点，即在解释我们的研究结果时考虑潜在的混杂因素（例如饮食和运动）很重要。 2 我们的研究不包括对患者的特定饮食咨询，也没有协同努力让患者坚持特定的低热量方案。在随访期间，患者接受了基于标准临床实践指南的按方案 (PP) 饮食咨询。这些指南强调碳水化合物摄入量、血糖指数和血糖控制之间的关系。考虑到愿意参加研究的患者通常更愿意改变行为，因此……