抗糖路上三只“拦路虎”

2017-10-13 张 瑾 人民网-生命时报

目前,我国约有1.13亿成年2型糖尿病患者,还有超过3亿人处于糖尿病前期,超过半数糖友的血糖控制未能达标,抗糖形势十分严峻。在中华医学会内分泌学分会主任委员、解放军总医院内分泌科主任母义明教授看来,糖尿病的防治效果,最容易受3种不良心态影响。

受访专家:解放军总医院内分泌科主任母义明

目前,我国约有1.13亿成年2型糖尿病患者,还有超过3亿人处于糖尿病前期,超过半数糖友的血糖控制未能达标,抗糖形势十分严峻。在中华医学会内分泌学分会主任委员、解放军总医院内分泌科主任母义明教授看来,糖尿病的防治效果,最容易受3种不良心态影响。

一是“拖延”

慢性病的共同的病因是不良的生活习惯,包括睡眠不足、饮食不均衡、缺少运动等。“不好好睡觉就会得病。”母义明教授提醒经常熬夜加班、上网的年轻人,睡眠不好会让神经系统长期处于兴奋状态,引起内分泌紊乱,增加糖尿病等多种疾病的风险。如果年轻时不重视,等到患病再后悔就晚了。

有人说,“糖尿病不早治,10年后就别治了”,话虽然说得有点重,但也从一个侧面反映出了糖尿病防治越及时越好。“糖尿病对身体的伤害,很大程度上是并发症带来的。这些并发症大多不可逆转,如果发现和治疗太晚,医学上也没有很好的办法。”母义明教授建议大家重视早期发现和治疗,别拖到出现并发症才就诊。

二是“选择困难

药物的效果、服用的便利性、价格和副作用,都是影响患者服药依从性的重要因素。一些糖友担心服药方法复杂或药物副作用大,不知该如何取舍。合理看待这些药物的优势和副作用,有助正确选用。

母义明教授介绍,传统一线降糖药中,二甲双胍在降糖同时能帮助患者减体重,但在用药者中出现消化道副作用比例较高,约40%;磺脲类药物效果也较为明确,但有引起低血糖的副作用。不过,这些药物只要遵医嘱合理使用,副作用是可以避免的。同时,二肽基肽酶-4(DPP-4)抑制剂具有服用方便、对胰岛β细胞有潜在保护作用等特点,目前也作为2型糖尿病的二线用药,在临床被广泛使用。

对部分糖友来说,口服降糖药、胰岛素的合理搭配,能降低用药量,改善治疗效果。因此,用药不要纠结,只要在医生指导下根据自身情况选择,并坚持治疗,定期复查,都能有效控制疾病进展,预防并发症。

三是“半途而废”

糖尿病治疗要打持久战。无论是服药、饮食还是运动,都不能半途而废,需要长期坚持。糖尿病的治疗是个长期的过程,随意停药、不注意管住嘴,都会影响治疗效果。

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    2017-10-25 虈亣靌

    不错的啊文章值得一读.

    0

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    2017-10-24 大爰

    学习了谢谢分享!!

    0

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    2017-10-18 1771ae4158m

    学习一下很不错

    0

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    2017-10-18 yfjms

    学习了

    0

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    2017-10-17 虈亣靌

    不错的.学习了.谢谢分享!

    0

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    2017-10-14 186****0580(小山羊)

    学习了谢谢了

    0

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