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预防糖尿病慢性并发症,六项监测不可少!

2016-10-17 佚名 “随糖”微信号(ID:suitang-s

糖尿病慢性并发症一般起病隐匿,进展缓慢,早期常缺乏明显的临床表现,一旦进展到临床阶段,其功能障碍常不可逆。因此,加强监测、筛选和早期诊断对糖尿病的预后十分重要。那么,预防糖尿病慢性并发症,哪些监测要做好?1、尿蛋白监测——预防糖尿病肾病目前,很多糖尿病患者只重视尿糖而忽略对尿蛋白的监测。实际上,有无尿蛋白是了解糖尿病肾病的依据,最能发现早期肾功能损害的指标是尿中微量白蛋白量。当病程大于3年时,应嘱

糖尿病慢性并发症一般起病隐匿,进展缓慢,早期常缺乏明显的临床表现,一旦进展到临床阶段,其功能障碍常不可逆。因此,加强监测、筛选和早期诊断对糖尿病的预后十分重要。


那么,预防糖尿病慢性并发症,哪些监测要做好?


1、尿蛋白监测——预防糖尿病肾病


目前,很多糖尿病患者只重视尿糖而忽略对尿蛋白的监测。实际上,有无尿蛋白是了解糖尿病肾病的依据,最能发现早期肾功能损害的指标是尿中微量白蛋白量。

当病程大于3年时,应嘱患者每年进行尿蛋白监测。一旦发现尿微量白蛋白大于20μg/min,则提示早期糖尿病肾病的发生,此阶段病变仍可逆,及时治疗可阻止病程的发展。

若尿蛋白大于200μg/min,则进入临床糖尿病肾病,病变为不可逆,最终会发展为肾衰竭。

2、眼底监测——预防糖尿病视网膜病变

视网膜病变是糖尿病最常见的微血管并发症,其最严重的后果是导致失明,是20~74岁成人致盲的首要原因。所有糖尿病患者每年均应进行眼底检查,以发现早期视网膜病变,对指导治疗具有重要价值。

3、血脂监测——预防动脉硬化性血管病变

糖尿病患者常有不同程度的血脂异常,而血脂异常可导致动脉硬化。糖尿病动脉粥样硬化的发生比一般人高3倍以上,动脉硬化易发生冠心病、高血压心肌梗死、脑血管病变等。因此,血脂监测对防治动脉硬化性血管病变至关重要。一般应每3~6个月测定一次血脂。


4、膀胱功能监测——预防糖尿病神经源性膀胱


糖尿病并发神经源性膀胱较常见,占糖尿病的26%~87%,但本病早期常无症状,往往到了尿潴留、反复尿路感染不愈甚至肾衰时才引起重视。

要想早期发现,应定期查尿常规和膀胱肾脏超声检查,以发现残余尿和肾盂积水,如患者膀胱尿量大于500ml仍无尿意,可考虑有膀胱功能的异常。

5、足部监测­——预防糖尿病足


糖尿病足是糖尿病患者特有的临床表现,严重的可致截肢,严重影响患者的生活质量。


因此,预防糖尿病足,需嘱咐患者每天检查足部皮肤的颜色,及对温度、压力和振动的感觉情况;检查足和下肢、足底间和足底部是否有创伤、发红、感染、磨损、流液、肿胀和擦伤;定期触诊足背动脉有无搏动减弱或消失。


6、血压监测——预防糖尿病并发高血压


30%~50%的糖尿病患者在病程中会发生高血压,其高血压患病率为非糖尿病患者的2~4倍,随病程延长和年龄增长而增加,且糖尿病并发高血压时,体内重要脏器已有不同程度的损害。


因此早期发现高血压至关重要,糖尿病患者应每月定期测一次血压,血压>130/80 mmHg时应予以治疗。

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1820200, encodeId=c4ee1820200b1, content=<a href='/topic/show?id=854a100358e6' target=_blank style='color:#2F92EE;'>#预防糖尿病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100358, encryptionId=854a100358e6, topicName=预防糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=56ea361, createdName=changhe713, createdTime=Sun Feb 12 19:40:00 CST 2017, time=2017-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1757748, encodeId=68471e57748b8, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Wed Sep 13 12:40:00 CST 2017, time=2017-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=156471, encodeId=aaca1564e1e0, content=这个还不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160807/IMG57A72B38A8C787546.jpg, createdBy=52b31714117, createdName=Anima, createdTime=Thu Nov 17 22:13:56 CST 2016, time=2016-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149352, encodeId=3e50149352ac, content=学习了,继续关注学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Tue Oct 18 05:33:35 CST 2016, time=2016-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149339, encodeId=20ee149339b7, content=这个挺不错的!, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161003/IMG57F1CC529F26A3108.jpg, createdBy=423a1960421, createdName=Deepblie, createdTime=Tue Oct 18 00:30:36 CST 2016, time=2016-10-18, status=1, ipAttribution=)]
    2017-09-13 丁鹏鹏
  3. [GetPortalCommentsPageByObjectIdResponse(id=1820200, encodeId=c4ee1820200b1, content=<a href='/topic/show?id=854a100358e6' target=_blank style='color:#2F92EE;'>#预防糖尿病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100358, encryptionId=854a100358e6, topicName=预防糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=56ea361, createdName=changhe713, createdTime=Sun Feb 12 19:40:00 CST 2017, time=2017-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1757748, encodeId=68471e57748b8, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Wed Sep 13 12:40:00 CST 2017, time=2017-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=156471, encodeId=aaca1564e1e0, content=这个还不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160807/IMG57A72B38A8C787546.jpg, createdBy=52b31714117, createdName=Anima, createdTime=Thu Nov 17 22:13:56 CST 2016, time=2016-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149352, encodeId=3e50149352ac, content=学习了,继续关注学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Tue Oct 18 05:33:35 CST 2016, time=2016-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149339, encodeId=20ee149339b7, content=这个挺不错的!, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161003/IMG57F1CC529F26A3108.jpg, createdBy=423a1960421, createdName=Deepblie, createdTime=Tue Oct 18 00:30:36 CST 2016, time=2016-10-18, status=1, ipAttribution=)]
    2016-11-17 Anima

    这个还不错

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1820200, encodeId=c4ee1820200b1, content=<a href='/topic/show?id=854a100358e6' target=_blank style='color:#2F92EE;'>#预防糖尿病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100358, encryptionId=854a100358e6, topicName=预防糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=56ea361, createdName=changhe713, createdTime=Sun Feb 12 19:40:00 CST 2017, time=2017-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1757748, encodeId=68471e57748b8, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Wed Sep 13 12:40:00 CST 2017, time=2017-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=156471, encodeId=aaca1564e1e0, content=这个还不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160807/IMG57A72B38A8C787546.jpg, createdBy=52b31714117, createdName=Anima, createdTime=Thu Nov 17 22:13:56 CST 2016, time=2016-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149352, encodeId=3e50149352ac, content=学习了,继续关注学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Tue Oct 18 05:33:35 CST 2016, time=2016-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149339, encodeId=20ee149339b7, content=这个挺不错的!, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161003/IMG57F1CC529F26A3108.jpg, createdBy=423a1960421, createdName=Deepblie, createdTime=Tue Oct 18 00:30:36 CST 2016, time=2016-10-18, status=1, ipAttribution=)]
    2016-10-18 半夏微凉

    学习了,继续关注学习!

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1820200, encodeId=c4ee1820200b1, content=<a href='/topic/show?id=854a100358e6' target=_blank style='color:#2F92EE;'>#预防糖尿病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100358, encryptionId=854a100358e6, topicName=预防糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=56ea361, createdName=changhe713, createdTime=Sun Feb 12 19:40:00 CST 2017, time=2017-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1757748, encodeId=68471e57748b8, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Wed Sep 13 12:40:00 CST 2017, time=2017-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=156471, encodeId=aaca1564e1e0, content=这个还不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160807/IMG57A72B38A8C787546.jpg, createdBy=52b31714117, createdName=Anima, createdTime=Thu Nov 17 22:13:56 CST 2016, time=2016-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149352, encodeId=3e50149352ac, content=学习了,继续关注学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Tue Oct 18 05:33:35 CST 2016, time=2016-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149339, encodeId=20ee149339b7, content=这个挺不错的!, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161003/IMG57F1CC529F26A3108.jpg, createdBy=423a1960421, createdName=Deepblie, createdTime=Tue Oct 18 00:30:36 CST 2016, time=2016-10-18, status=1, ipAttribution=)]
    2016-10-18 Deepblie

    这个挺不错的!

    0

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糖尿病患者们总是生活的战战兢兢,他们心里时刻想着“这个不能多吃,吃了血糖又要高了!”诚然,对于糖尿病患者来说,如何控制血糖是非常重要的,不过,除了控制外,监测的意义也不应该被小觑。除了血糖之外,还有一个大家可能不太熟悉的指标——糖化血红蛋白(HbA1c)。HbA1c是人体血液中红细胞内的血红蛋白与血糖结合的产物,是衡量糖尿病控制水平的标准,血糖和血红蛋白结合生成糖化血红蛋白是不可逆反应,大约能够保

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本研究纳入了TECOS试验中的患者,为2型糖尿病和心血管疾病患者,使用二肽基肽酶4抑制剂西他列汀治疗,评估这些患者的慢性肾脏疾病(CKD)和心血管结局。 研究纳入了14671例患者,根据基线估计的肾小球滤过率(eGFR)将患者分类:1、2、3a和3b期(对应的eGFR值分别为≥90、60–89、45–59和30–44 mL/min/1.73 m2),研究的中位时间超过3年,评估患者的心血管和

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