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Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
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糖尿病前期:治疗还是不治疗?

Rajesh Agrawal1

  • 1Secretary, RSSDI, Madhya Pradesh; CEO, Department of Medicine, Diabetes Overweight Thyroid and Hormone Clinic, Indore, Madhya Pradesh, India, Corresponding Author, Orcid: https://orcid.org/0009-0007-1237-210X.

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PubMed
概括
此摘要是机器生成的。

糖尿病前期 (PD) 显著增加患2型糖尿病 (T2DM) 和心血管问题的风险. 通过改变生活方式或药物治疗的早期干预对于高风险个体来说至关重要,以防止进展.

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科学领域:

  • 内分泌学 在内分泌学.
  • 代谢障碍 代谢障碍 代谢障碍
  • 公共卫生 公共卫生

背景情况:

  • 糖尿病前期 (PD) 是正常血糖和2型糖尿病 (T2DM) 之间的关键阶段,其特点是快食葡萄糖受损 (IFG),葡萄糖耐受性受损 (IGT) 或HbA1c在5.7%至6.4%之间.
  • 患有PD的个人每年面临5-10%的进展到T2DM的风险,并且容易发生微型和宏观血管并发症,包括心血管疾病.
  • 全球PD的患病率很大,预计会上升,这凸显了迫切需要预防策略来减轻与T2DM相关的发病率,死亡率和医疗负担.

研究的目的:

  • 评估治疗糖尿病前期 (PD) 的重要性和必要性,以防止发展为2型糖尿病 (T2DM) 和相关并发症.
  • 审查生活方式干预和药物治疗在治疗PD和减少T2DM发病率方面的有效性.
  • 讨论围绕PD治疗的争议,包括过度诊断,过度药物治疗以及长期风险效益分析的必要性.

主要方法:

  • 关于糖尿病前期诊断,风险因素,进展和治疗结果的现有文献的综述.
  • 分析了像糖尿病预防计划 (DPP) 这样具有里程碑意义的研究数据.
  • 讨论目前的治疗指南和专家推的PD药物治疗.

主要成果:

  • 强烈的生活方式修改 (饮食,运动,减肥) 可以将PD的T2DM进展率降低40-70%并改善心血管健康.
  • 针对胰岛素抵抗和葡萄糖生产的药物治疗,包括甲福明,SGLT2抑制剂,DPP IV抑制剂和GLP1RA,在预防T2DM方面表现出有效性.
  • 糖尿病预防计划 (DPP) 显示,在使用甲福林时,T2DM发病率降低了31%.
  • 虽然存在药物治疗选择,但由于潜在的不良影响和缺乏共识,特别是对于非甲胺药物,它们在PD中的使用仍在争论中.

结论:

  • 由于患有T2DM进展和并发症的高风险,PD的积极管理至关重要.
  • 生活方式干预非常有效,但对于具有强烈家族病史,严重胰岛素抵抗,肥胖或并发症的高风险个体,应考虑药物治疗.
  • 需要进行进一步的长期研究,以充分确定PD中药物治疗的风险益处概况,并建议对所有被诊断为PD的个人进行定期监测.