Investigation as soon as possible to protect the heart of diabetic
Posted on October 18, 2009
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Pre-diabetes (including impaired glucose tolerance and impaired fasting glucose) ranged between normal and diabetes is a reserve army of diabetes, if the timely detection and intervention in pre-diabetes, can delay the occurrence of diabetes, and even reverse the abnormal glucose metabolism. However, pre-diabetes are mostly asymptomatic, onset hidden, so high-risk groups should be actively screening for the early detection.
According to the 1999 World Health Organization diagnostic criteria:
1, impaired fasting glucose defined as fasting blood glucose in the 6.1-7.0mmol / L (mmol / l), more than 7.0mmol / L (mmol / l) compared with diabetes;
2, impaired glucose tolerance is defined as the 75 g oral glucose tolerance test (OGTT) 2 hour plasma glucose of 7.8-11.1mmol / L, more than 11.1mmol / L, compared with diabetes.
Can be seen frequently measured physical examination will be missed most of the fasting blood glucose (about 2 / 3) in patients with pre-diabetes. Therefore, in order to be diagnosed with impaired glucose tolerance to OGTT.
Analysis of knowledge – how to do oral glucose tolerance test
Treated with oral glucose tolerance test (OGTT) before the 3 days diet is relatively normal, mainly because the other empty. Many people are receiving checks were slightly higher fasting plasma glucose, and then further examine the former are often deliberately dieting, so that could lead to test results are not allowed. The so-called normal diet, generally require a daily staple food to more than 3 2. Subjects fasted the night before to be more than 8 hours. Subjects first morning fasting blood glucose extraction, and then 5 minutes to drink 250-300 ml of syrup (which contains 75 grams anhydrous glucose), water temperature should not be too cold, so as not to affect the sugar dissolves. From time to drink the first one, 2 hours after taking the blood glucose measurements. Test requirements in the near future subjects without infection, surgery and trauma stress situations, testing them not to smoke, drink coffee and vigorous exercise, otherwise they will affect the determination of blood glucose results, delays in diagnosis.
Who should be screened for pre-diabetes
At present that:
* Aged 45 and above;
* Younger, but accompanied by overweight or obese;
* Or have family history of diabetes;
* There is a history of gestational diabetes mellitus
The above four types of people should be carried out pre-diabetes screening. Fasting blood glucose to determine the fasting glucose to carry out OGTT identified abnormal glucose tolerance. Routine fasting blood glucose and other clinical indicators such as body mass index (BMI), blood pressure and lipid profile such as to determine the individual level of risk of diabetes, fasting blood glucose and OGTT between the two in combination can be more effective and comprehensive screening of patients with pre-diabetes.
Diagnosed with pre-diabetes have to take medicine to protect the heart after
Fasting blood sugar is not high, but the increase in glucose after meals, which is a pre-diabetes, this medication should not it? In the past, the doctor will guide the patient lifestyle changes, such as diet, exercise, etc., but now, doctors will tell patients, lifestyle changes should be accompanied by the medication as soon as possible. Held in recent evaluation studies of acarbose (ACE) press conference, People’s Liberation Army General Hospital, said Professor Pan Changyu, abnormal glucose metabolism to early intervention, with the ultimate aim is not only to reduce blood sugar, but in order to reduce cardiovascular events , that is, protect the heart.
* Injury to the heart of postprandial hyperglycemia
Many patients, fasting plasma glucose test is normal, but the meal or received oral glucose tolerance test, you will find significantly more than normal blood sugar, which range between normal and diabetes is a state of pre-diabetes, also known as impaired glucose tolerance by the loss. Many people feel that do not is a slightly higher blood glucose and should be no harm. However, Karolinska professor at the University of Dayton Lasry said the heart of Europe investigations and surveys have shown that the heart of China, diabetes and myocardial infarction are a pair of lethal combinations. The coronary heart disease patients, abnormal glucose metabolism (including diabetes and pre-diabetes) than we have imagined universal. “A lot of studies have shown that postprandial hyperglycemia and cardiovascular disease incidence and mortality rates close.” Visible, even if not yet developed to the stage of diabetes, pre-diabetes patient’s heart also faces great risk.
* There are three major advantages of early administration
According to the Chinese Medical Association Diabetes credits will be the latest epidemiological survey, prevalence of diabetes in Chinese urban residents was 11%, pre-diabetes prevalence rate was about 15%, that is, the community has a diabetes patient, almost about to have a into the ranks of pre-diabetes in patients with diabetes mellitus. According to experts, without intervention, about 1 / 3 of patients with pre-diabetes will develop diabetes.
And, if only fasting blood glucose, there is a large part of patients with abnormal glucose metabolism has been missed, especially in patients with pre-diabetes. For this reason, the University of Oxford Diabetes Center Waruiheman professor said that in 2007 the United States and Europe, “diabetes, pre-diabetes and cardiovascular disease guidelines” were recommended oral glucose tolerance test fasting blood glucose and postprandial glucose, with a view to early detection of Asymptomatic hyperglycemia and type 2 diabetes. Moreover, early intervention has become the United States and Europe specialist diabetes medical consensus.
Professor Pan Changyu pointed out that if able to postprandial blood glucose under control, there are three major advantages: First, effective control of blood glucose and glycated hemoglobin, the second is to reduce pre-diabetes progressed to the risk of type 2 diabetes and the third is to reduce the patient’s cardiovascular risk, which point is the most important.
* Blood sugar a another job started to take medicine
Since the pre-diabetes should actively treated, how do drugs? Professor Pan Changyu, said Acarbose is currently the only applied to pre-diabetes drug, has been approved in 27 countries. There are a number of research evidence that the use of acarbose treatment in patients with the risk of diabetes and myocardial infarction were significantly reduced, is the only evidence of cardiovascular benefits of hypoglycemic drugs.
Pan Chang-yu said that acarbose security is good, the burden of liver and kidney is small, not to increase the weight, does not produce low blood sugar in China has been widely used and accepted by
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