[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:Now that duck tails into what we were speaking about yesterday with Dr Handlesman and that is it seems that the WHO,the IDF,and the ADA are trying to work out some baseline number of A1c and in ease of the opinion that it is not going to shake out for several years as to what that number should be,what do you think?

《国际糖尿病》:让我们探讨一下昨天与Handlesman教授谈及的话题,就是似乎世界卫生组织、国际糖尿病联合会、美国糖尿病协会正在制定A1c的基线数据,这不难想象,还需要几年时间才能确定出这个数据,您是怎么看待这件事情的呢?

    Dr Bloomgarden:I think that if we think that diabetes is a disease of blood sugar,even though we reconigze that in a given person blood sugar will vary from day to day and from week to week and so that is a little bit undesireable level since it might change,but this is different from the variation from one person to another of A1c.  And so I am rather against the idea of the A1c of a diagnostic tool.  That is not to say that I do not think that A1c is a useful measure in people with diabetes and it is certainly as the A1c level becomes higher in a person without diabetes my index of suspicion is greater and greater that they do have diabetes but I would also want to refer to actual blood sugars to make the diagnosis and of course when I treat someone with diabetes I do not feel comfortable treating based on A1c alone as the criterion of success or failure and I think that we should in the same spirit, think of A1c in the context of blood sugars when we look at how a person with diabetes is doing.

Bloomgarden教授:我认为,如果我们认为糖尿病是一个关于血糖的疾病,那么即使我们认识到在一个既定个体,血糖每天或者每周会有所改变,并且这些可能存在的改变使得将血糖作为诊断标准有点不情愿,但是我们应该知道,这种改变有别于A1c人与人之间的改变。因此我相当反对将A1c作为诊断糖尿病的工具。这不是说我认为A1c在糖尿病人中不是一个有用的工具,而是在没有糖尿病的一些人中A1c水平会变得更高,我越来越怀疑他们实际上没有糖尿病,我还是要参考实际血糖来做出诊断。当然,当我治疗糖尿病患者的时候,如果单独使用A1c作为评价成功与否的标准,我会感到不舒服。我认为,在观察糖尿病人情况的时候,我们应该具有相同的原则,就是将A1c作为血糖之下的次要标准来使用。
 



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非常赞同Bloomgarden教授的观点

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