预防糖尿病慢性并发症,六项监测不可少!

2016-10-17 佚名 “随糖”微信号(ID:suitang-s

糖尿病慢性并发症一般起病隐匿,进展缓慢,早期常缺乏明显的临床表现,一旦进展到临床阶段,其功能障碍常不可逆。因此,加强监测、筛选和早期诊断对糖尿病的预后十分重要。那么,预防糖尿病慢性并发症,哪些监测要做好?1、尿蛋白监测——预防糖尿病肾病目前,很多糖尿病患者只重视尿糖而忽略对尿蛋白的监测。实际上,有无尿蛋白是了解糖尿病肾病的依据,最能发现早期肾功能损害的指标是尿中微量白蛋白量。当病程大于3年时,应嘱

糖尿病慢性并发症一般起病隐匿,进展缓慢,早期常缺乏明显的临床表现,一旦进展到临床阶段,其功能障碍常不可逆。因此,加强监测、筛选和早期诊断对糖尿病的预后十分重要。


那么,预防糖尿病慢性并发症,哪些监测要做好?


1、尿蛋白监测——预防糖尿病肾病


目前,很多糖尿病患者只重视尿糖而忽略对尿蛋白的监测。实际上,有无尿蛋白是了解糖尿病肾病的依据,最能发现早期肾功能损害的指标是尿中微量白蛋白量。

当病程大于3年时,应嘱患者每年进行尿蛋白监测。一旦发现尿微量白蛋白大于20μg/min,则提示早期糖尿病肾病的发生,此阶段病变仍可逆,及时治疗可阻止病程的发展。

若尿蛋白大于200μg/min,则进入临床糖尿病肾病,病变为不可逆,最终会发展为肾衰竭。

2、眼底监测——预防糖尿病视网膜病变

视网膜病变是糖尿病最常见的微血管并发症,其最严重的后果是导致失明,是20~74岁成人致盲的首要原因。所有糖尿病患者每年均应进行眼底检查,以发现早期视网膜病变,对指导治疗具有重要价值。

3、血脂监测——预防动脉硬化性血管病变

糖尿病患者常有不同程度的血脂异常,而血脂异常可导致动脉硬化。糖尿病动脉粥样硬化的发生比一般人高3倍以上,动脉硬化易发生冠心病、高血压心肌梗死、脑血管病变等。因此,血脂监测对防治动脉硬化性血管病变至关重要。一般应每3~6个月测定一次血脂。


4、膀胱功能监测——预防糖尿病神经源性膀胱


糖尿病并发神经源性膀胱较常见,占糖尿病的26%~87%,但本病早期常无症状,往往到了尿潴留、反复尿路感染不愈甚至肾衰时才引起重视。

要想早期发现,应定期查尿常规和膀胱肾脏超声检查,以发现残余尿和肾盂积水,如患者膀胱尿量大于500ml仍无尿意,可考虑有膀胱功能的异常。

5、足部监测­——预防糖尿病足


糖尿病足是糖尿病患者特有的临床表现,严重的可致截肢,严重影响患者的生活质量。


因此,预防糖尿病足,需嘱咐患者每天检查足部皮肤的颜色,及对温度、压力和振动的感觉情况;检查足和下肢、足底间和足底部是否有创伤、发红、感染、磨损、流液、肿胀和擦伤;定期触诊足背动脉有无搏动减弱或消失。


6、血压监测——预防糖尿病并发高血压


30%~50%的糖尿病患者在病程中会发生高血压,其高血压患病率为非糖尿病患者的2~4倍,随病程延长和年龄增长而增加,且糖尿病并发高血压时,体内重要脏器已有不同程度的损害。


因此早期发现高血压至关重要,糖尿病患者应每月定期测一次血压,血压>130/80 mmHg时应予以治疗。

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1820200, encodeId=c4ee1820200b1, content=<a href='/topic/show?id=854a100358e6' target=_blank style='color:#2F92EE;'>#预防糖尿病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100358, encryptionId=854a100358e6, topicName=预防糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=56ea361, createdName=changhe713, createdTime=Sun Feb 12 19:40:00 CST 2017, time=2017-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1757748, encodeId=68471e57748b8, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Wed Sep 13 12:40:00 CST 2017, time=2017-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=156471, encodeId=aaca1564e1e0, content=这个还不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160807/IMG57A72B38A8C787546.jpg, createdBy=52b31714117, createdName=Anima, createdTime=Thu Nov 17 22:13:56 CST 2016, time=2016-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149352, encodeId=3e50149352ac, content=学习了,继续关注学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Tue Oct 18 05:33:35 CST 2016, time=2016-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149339, encodeId=20ee149339b7, content=这个挺不错的!, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161003/IMG57F1CC529F26A3108.jpg, createdBy=423a1960421, createdName=Deepblie, createdTime=Tue Oct 18 00:30:36 CST 2016, time=2016-10-18, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1820200, encodeId=c4ee1820200b1, content=<a href='/topic/show?id=854a100358e6' target=_blank style='color:#2F92EE;'>#预防糖尿病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100358, encryptionId=854a100358e6, topicName=预防糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=56ea361, createdName=changhe713, createdTime=Sun Feb 12 19:40:00 CST 2017, time=2017-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1757748, encodeId=68471e57748b8, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Wed Sep 13 12:40:00 CST 2017, time=2017-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=156471, encodeId=aaca1564e1e0, content=这个还不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160807/IMG57A72B38A8C787546.jpg, createdBy=52b31714117, createdName=Anima, createdTime=Thu Nov 17 22:13:56 CST 2016, time=2016-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149352, encodeId=3e50149352ac, content=学习了,继续关注学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Tue Oct 18 05:33:35 CST 2016, time=2016-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149339, encodeId=20ee149339b7, content=这个挺不错的!, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161003/IMG57F1CC529F26A3108.jpg, createdBy=423a1960421, createdName=Deepblie, createdTime=Tue Oct 18 00:30:36 CST 2016, time=2016-10-18, status=1, ipAttribution=)]
    2017-09-13 丁鹏鹏
  3. [GetPortalCommentsPageByObjectIdResponse(id=1820200, encodeId=c4ee1820200b1, content=<a href='/topic/show?id=854a100358e6' target=_blank style='color:#2F92EE;'>#预防糖尿病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100358, encryptionId=854a100358e6, topicName=预防糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=56ea361, createdName=changhe713, createdTime=Sun Feb 12 19:40:00 CST 2017, time=2017-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1757748, encodeId=68471e57748b8, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Wed Sep 13 12:40:00 CST 2017, time=2017-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=156471, encodeId=aaca1564e1e0, content=这个还不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160807/IMG57A72B38A8C787546.jpg, createdBy=52b31714117, createdName=Anima, createdTime=Thu Nov 17 22:13:56 CST 2016, time=2016-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149352, encodeId=3e50149352ac, content=学习了,继续关注学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Tue Oct 18 05:33:35 CST 2016, time=2016-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149339, encodeId=20ee149339b7, content=这个挺不错的!, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161003/IMG57F1CC529F26A3108.jpg, createdBy=423a1960421, createdName=Deepblie, createdTime=Tue Oct 18 00:30:36 CST 2016, time=2016-10-18, status=1, ipAttribution=)]
    2016-11-17 Anima

    这个还不错

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1820200, encodeId=c4ee1820200b1, content=<a href='/topic/show?id=854a100358e6' target=_blank style='color:#2F92EE;'>#预防糖尿病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100358, encryptionId=854a100358e6, topicName=预防糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=56ea361, createdName=changhe713, createdTime=Sun Feb 12 19:40:00 CST 2017, time=2017-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1757748, encodeId=68471e57748b8, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Wed Sep 13 12:40:00 CST 2017, time=2017-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=156471, encodeId=aaca1564e1e0, content=这个还不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160807/IMG57A72B38A8C787546.jpg, createdBy=52b31714117, createdName=Anima, createdTime=Thu Nov 17 22:13:56 CST 2016, time=2016-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149352, encodeId=3e50149352ac, content=学习了,继续关注学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Tue Oct 18 05:33:35 CST 2016, time=2016-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149339, encodeId=20ee149339b7, content=这个挺不错的!, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161003/IMG57F1CC529F26A3108.jpg, createdBy=423a1960421, createdName=Deepblie, createdTime=Tue Oct 18 00:30:36 CST 2016, time=2016-10-18, status=1, ipAttribution=)]
    2016-10-18 半夏微凉

    学习了,继续关注学习!

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1820200, encodeId=c4ee1820200b1, content=<a href='/topic/show?id=854a100358e6' target=_blank style='color:#2F92EE;'>#预防糖尿病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100358, encryptionId=854a100358e6, topicName=预防糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=56ea361, createdName=changhe713, createdTime=Sun Feb 12 19:40:00 CST 2017, time=2017-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1757748, encodeId=68471e57748b8, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Wed Sep 13 12:40:00 CST 2017, time=2017-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=156471, encodeId=aaca1564e1e0, content=这个还不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160807/IMG57A72B38A8C787546.jpg, createdBy=52b31714117, createdName=Anima, createdTime=Thu Nov 17 22:13:56 CST 2016, time=2016-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149352, encodeId=3e50149352ac, content=学习了,继续关注学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Tue Oct 18 05:33:35 CST 2016, time=2016-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149339, encodeId=20ee149339b7, content=这个挺不错的!, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161003/IMG57F1CC529F26A3108.jpg, createdBy=423a1960421, createdName=Deepblie, createdTime=Tue Oct 18 00:30:36 CST 2016, time=2016-10-18, status=1, ipAttribution=)]
    2016-10-18 Deepblie

    这个挺不错的!

    0

相关资讯

JCI:重磅!科学家鉴别出抵御肥胖和糖尿病的新型潜在靶点

图片摘自:www.mirror.co.uk 对我们来说,减肥很困难已然不是什么秘密了,每年都会有一种受欢迎的饮食方式保证能够让我们获得苗条的身材,然而如今在美国肥胖的爆发和流行趋势依旧在继续;当前抵御肥胖的疗法仅仅是部分有效的,而且由于其存在一些副作用,体重的减轻或许只是暂时的,而且相当一部分患者对这种减肥疗法或许并没有什么反应。 近日,一项刊登于国际杂志Journal of Clinic

JCEM:甲状腺和胰岛自身抗体预测1型糖尿病患者的自身免疫性甲状腺疾病

对1型糖尿病儿童和年轻成人患者进行自身免疫性甲状腺疾病的筛查是很重要的。 本研究的目的是,评估甲状腺自身抗体、甲状腺功能、胰岛自身抗体和HLA-DQ对1型糖尿病患者的自身免疫性甲状腺疾病的预测价值。 研究纳入了2433例1型糖尿病儿童患者,检测患儿的抗甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)、谷氨酸脱羧酶抗体(GADA)、胰岛素(IAA)、胰岛素瘤相关蛋白-2(

J Clin Endocrinol Metab:较高的雄激素水平可降低胰岛素抵抗及糖尿病的发病风险

近日,一项新的研究发现表明,老年男性中雄激素水平升高可降低胰岛素抵抗,及糖尿病的发病风险。研究纳入了来自于心血管健康研究(1994年)的852名无糖尿病和心血管疾病的研究对象,以确定性激素与胰岛素抵抗和糖尿病发生之间的关系。使用胰岛素抵抗稳态模型评估(HOMA-IR)来评估胰岛素抵抗,使用Gutt指数来估计胰岛素敏感性。平均随访9.8年。校正人口特征、饮酒、吸烟、BMI后,发现SHBG和双氢睾酮与

STM:哈佛大学科学家——你们现在估算平均血糖的金标准是不准确的!

糖尿病患者们总是生活的战战兢兢,他们心里时刻想着“这个不能多吃,吃了血糖又要高了!”诚然,对于糖尿病患者来说,如何控制血糖是非常重要的,不过,除了控制外,监测的意义也不应该被小觑。除了血糖之外,还有一个大家可能不太熟悉的指标——糖化血红蛋白(HbA1c)。HbA1c是人体血液中红细胞内的血红蛋白与血糖结合的产物,是衡量糖尿病控制水平的标准,血糖和血红蛋白结合生成糖化血红蛋白是不可逆反应,大约能够保

Diabetes Care:西他列汀对2型糖尿病患者的肾功能和心血管结局有什么影响?

本研究纳入了TECOS试验中的患者,为2型糖尿病和心血管疾病患者,使用二肽基肽酶4抑制剂西他列汀治疗,评估这些患者的慢性肾脏疾病(CKD)和心血管结局。 研究纳入了14671例患者,根据基线估计的肾小球滤过率(eGFR)将患者分类:1、2、3a和3b期(对应的eGFR值分别为≥90、60–89、45–59和30–44 mL/min/1.73 m2),研究的中位时间超过3年,评估患者的心血管和