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中国成人2型亚博手机app预防的专家共识精要
作者:中糖院 时间:2020-10-09 10:34:46 浏览:109

 2 xingyaboshoujiapp(t2dm)youyaboshoujiappqianqifazhanerlai。 yaboshoujiappqianqikeyibeirenweishiyizhongbiaozhihuofenshuiling,tadechuxianbiaozhizhejianglaifashengnaoxinxueguanbing(cerebro cardiovascular disease,ccvd)、yaboshoujiapp、weixueguanbingyijizhongliuhechidaidengdeweixianxingzenggao。xianyoudeyanjiuyizhengmingyouxiaoganyuyaboshoujiappqianqikemingxianjianshaoqizhuanhuaweiyaboshoujiapp。yinci,jishifaxianxuetangzhengchangxingyaboshoujiappgaoweirenqunheyaboshoujiappqianqirenqunbingjinxingyouxiaoguanlishiyufangyaboshoujiappfashengdeguanjian。

2008年中华医学会亚博手机app学分会(CDS)组织的中国14省亚博手机app流行病学调查结果显示,在 20 岁以上的人群中,年龄标化的亚博手机app患病率为9.7%,患病人数达 9240 万例,居全球之首;而亚博手机app前期的患病率高达15.5%,人数在14800万以上。
亚博手机app调查发现,男性亚博手机app前期患病率为16.1%,其中空腹血糖受损(Impaired Fasting Glucose/glycemia,IFG)、糖耐量减低(Impaired Glucose Tolerance,IGT)与IFG 合并IGT分别为 3.2%、11.0% 和 1.9%;女性亚博手机app前期患病率为 14.8%,IFG、IGT 和 IFG 合并 IGT 分别为2.2%、10.9%与 1.7%。

zhenduanweiyaboshoujiappqianqiderenqunzhong,nanxingifg zhan 19.9%,igt zhan 68.3%,ifg+igt zhan11.08%;nvxingifg zhan 14.9%,igt zhan 73.6%,ifg+igt zhan 11.5%。2010 nianwanchengdewoguo 18 suiyishangchengrenliuxingbingxuediaocha,gusuandeyaboshoujiappqianqihuanbinglvwei50.1%。zheilianggedaxingyanjiushuomingwoguoyaboshoujiappqianqihuanbinglvgaoqieyicanhougaoxuetangweizhu。ciwai,youyuyaboshoujiappqianqiyiban wulinchuangbiaoxian,qishouzhongshichengduyuanyuanbugou。jianyuci,zhonghuayixuehuineifenmixuefenhuiyu 2013nianzhidinglezhongguochengren 2 xingyaboshoujiappyufangdezhuanjiagongshi。

1  gongshizhuyaoneirong

亚博手机app1.1  zhengjudengji  canzhaowenxianmeiguoyaboshoujiappxuehui(ada)dezhengjudengjifenjibiaozhun,biaozhuyuxiangyingzhengjuhoudekuohaozhong。

亚博手机app1.2  yaboshoujiappgaoweirenqundingyi  yaboshoujiappgaoweirenqunbaokuoxuetangzhengchangxinggaoweirenqunheyaboshoujiappqianqirenqun。

1.2.1  xuetangzhengchangxinggaoweirenqun  chengnianren(>18 sui)juyouxialierenheyigejiyishangdeyaboshoujiappgaoweiyinsu,kedingyiweiyaboshoujiappgaoweirenqun:(1)nianling≥40 sui;(2)jiwangyouyaboshoujiappqianqibingshi;(3)chaozhong、feipang[tizhizhishu(bmi)≥24)],nanxingyaowei≥90cm,nvxingyaowei≥85cm;(4)jingzuodeshenghuofangshi; (5)yijiqinshuzhongyou 2xingyaboshoujiappjiazushi;(6)youjudaer(chushengtizhong≥4kg)shengchanshi,huorenshenqixianxingyaboshoujiapphuorenshenyaboshoujiapp(gdm)shidefunv;(7)gaoxueya[shousuoya ≥140mmhg he(huo)shuzhangya≥90mmhg],huozhengzaijieshoujiangyazhiliao;(8)xuezhiyichang[gaomiduzhidanbaidanguchun(hdl-c)≤0.91mmol/l jisanxianganyou(tg)≥2.22mmol/l,huozhengzaijieshoudiaozhizhiliao];(9)dongmaizhouyangyinghuaxingccvd huanzhe;(10)youyiguoxingleiguchunxingyaboshoujiappbingshizhe;(11)duonangluanchaozonghezheng(pcos)huanzhe;(12)yanzhongjingshenbinghe(huo)zhangqijieshoukangyiyuzhengyaowuzhiliaodehuanzhe。

1.2.2  亚博手机app前期人群  亚博手机app前期指空腹血浆葡萄糖(FPG)或(和)口服葡萄糖耐量试验(OGTT)2 h 血浆葡萄糖(2hPG)升高但未达到亚博app下载的诊断标准,即存在IFG 或IGT 或两者兼具(IFG + IGT)。 亚博手机app前期的诊断标准见表 1。本文除特别注明外,亚博手机app前期的诊断即同表 1。

中国成人2型亚博手机app预防的专家共识精要

1.3  亚博手机app高危人群的筛查

亚博手机appwuyaboshoujiappbingshizhe,shouxiangenjugaoweiyinsu(tongshang)jinxingchushai,duiyujuyouyixiangweixianyinsuzhejinyibujinxing fpg huorenyidianxuetang(rpg)shaicha。(1)fpg:jianyiyi fpg≥5 6 mmol/ l zuoweixingkoufuputaotangnailiangshiyan(ogtt)deqiedian。(2)rpg:jianyiyi rpg≥7.8 mmol/ l zuoweixing ogtt deqiedian。(3)youyu fpg<5.6 mmol/ l huo rpg <7.8 mmol/ l derenquntebieshilaonianrenqunbunengwanquanpaichuigt jicanhouxuetangshenggaodeyaboshoujiapp,yincilaonianjiqitagaoweizhe(quezhenguanxinbinghuohebingjiaoduoweixianyinsu)yejianyixing ogtt mingquexuetangdaixiedeqingkuang。

亚博手机app1.4  yaboshoujiappgaoweirenqundeguanli

亚博手机app1.4.1  xuetangzhengchangxingyaboshoujiappgaoweirenqundeguanli

亚博手机app(1)jiankangjiaoyu:muqianquefazhengjuyugongshi。cankaoyaboshoujiappjiankangjiaoyu,jianyimeiweigaoweizhehe(huo)jiashu(zhaohuzhe)yingjieshouxitongxingdejiaoyu,bingqiezuodaomeiniangongguyici。jiaoyudeneirong zhishaoyingbaokuoyaboshoujiappqianqijiyaboshoujiappxiangguanzhishi,rushenmeshiyaboshoujiappqianqijiyaboshoujiapp、yixueyingyangzhiliao、yundonghejieyandejibenzhishideng;ciwaihaiyingbaokuogairenqundeqitaccvd fengxiandeguanlizhishi。

(2)其他干预:①生活方式干预。这是干预的基础。应建议通过医学营养治疗和运动等强化生活方式干预减少发生亚博app下载的风险。推荐肥胖或超重者控制至正常 BMI < 24,或体重至少减少 5% ~ 10%;每日饮食总热量至少减少1680 ~2100 kJ;饱和脂肪酸摄入占总脂肪酸摄入的30%以下;体力活动时间增加到 250 ~ 300 min/周。 开始生活方式干预后,须定期随访其执行度。②其他CCVD风险的管理,如血压、血脂同等重要,详细指标见控制目标部分。

(3)监测:开始生活方式干预后,须定期随访该人群的血糖变化情况,建议每年至少一次于医院行 FPG 和(或)OGTT 检查。

1.4.2  yaboshoujiappqianqirenqundeguanli