[WCIR2009]糖尿病诊断进展与个体化治疗--Z.Bloomgarden教授访谈:
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专家访谈 临床科研 作者:ZacharyT.Bloomgarden 来源:未知 2009/12/1 9:47:00    加入收藏
内容概要:《国际糖尿病》:糖化血红蛋白(HbA1c)或联合空腹血糖(FPG)被建议用作糖尿病的诊断标准已有很长的时间了,这些建议是否已被广泛采纳,还是仍需进一步研究验证?

    International Diabetes:Speaking of individualized treatment,at the clinical setting are there any other considerations that clinicians should have for individualizing their assessment of diabetes in patients?


《国际糖尿病》:说到个体化治疗,在临床上,医生在对糖尿病人做出个体化评价时,他们应该还要考虑其它哪些问题呢?

    Dr Bloomgarden:Well of course we want to use treatment that does not cause drops in blood sugar. We want to be careful about treatments that tend to cause weight gain. We want to use treatments that are not associated with gastrointestinal side effects we want to be careful about kidney functions and various treatments so there are a host of individual factors that are importants.  We now have to realize that drops in blood sguar can be very serious in people with diabetes so using medicines that can cause blood sugar drops and using therapeutic approaches were we extremely and intensively treat people with diabetes at the expense of hypoglycemia may not be correct.  And that certainly appears to be true in people at greatest cardiovascular risk.  But I would not go  from that to what some people have said which is that now we think that glucose control does not matter.  I think there is a huge amount of evidence that glucose control matters for prevention of complications and there is growing understanding that glucose control appears to be of importance to preventing cardiovascular complications when done in the right way.  

Bloomgarden教授:当然我们要使用不会引起血糖下降的治疗方法;我们要谨慎于有增加体重趋向的治疗方法;我们要使用不存在胃肠道副反应的治疗方法;我们要注意肾功能,还要注意其它的一些治疗方法。因此要掌握重要的个体因素。我们现在必须意识到,在糖尿病人中血糖下降是很严重的。因此,使用能够引起血糖下降的药物或者治疗糖尿病方法极端或过于强烈引起低血糖血症,这些都是不正确的。在具有非常高心血管疾病发生危险的人群中这是真理。但是我们不会由此走向一些人所认为的控制血糖不重要这样的误区。我认为有大量的数据表明控制血糖对阻止并发症很重要。如果方法适当,控制血糖对阻止心血管疾病并发症很重要,这一点也逐渐得到认识。
 



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非常赞同Bloomgarden教授的观点

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