第一课糖尿病概论.pptVIP

* 糖尿病患者往往伴有脂代谢紊乱，从而增加患者心脑血管疾病的危险性，故糖尿病 患者还必须经常检测血脂。糖尿病患者血脂达标的标准为：总胆固醇 4.5毫摩尔/升；甘油三酯1.5毫摩尔/升；高密度脂蛋白胆固醇1.1毫摩尔/升；低密度脂蛋白胆固醇2.6毫摩尔/升。建议至少每半年测一次血脂。 * 血脂与胰岛素抵抗和动脉粥样硬化关系十分密切，有人称血脂异常为“油腻的杀手”。 糖尿病病人血脂容易不正常，主要表现在高密度脂蛋白降低，而低密度脂蛋白升高，同时胆固醇和甘油三酯水平也升高，结果造成高血压、动脉粥样硬化及心、脑血管病增多，严重者还造成患者死亡。此外，血脂异常症患者肥胖、高血压、痛风、肝胆及胰腺疾病的发生率也增高，必须加以防治。 糖尿病患者血脂达标的标准为：总胆固醇 4.5毫摩尔/升，甘油三酯 1.5毫摩尔/升，高密度脂蛋白胆固醇1.1毫摩尔/升，低密度脂蛋白胆固醇2.6毫摩尔/升。 血糖和血脂密切相关 要想治疗糖尿病的脂质异常症，首先必须控制好血糖，血糖降低后，血脂，尤其是甘油三酯水平会显著下降。另外，血脂的部分来自饮食，糖尿病病人宜进食高纤维低脂饮食，特别是要少吃富含饱和脂肪酸的动物油，以及富含胆固醇的动物内脏和鱼卵、蟹黄、虾子等海产动物食品。同时还要戒烟并少饮酒。另外，运动疗法对血脂异常症和肥胖的控制也很有益。如果采取了上面所说的这些措施后，血脂仍不正常，则必须同时服用调脂药物。这类药多需要长期甚至终身服用。还有，经常参加体检对减肥和调脂也十分重要，定期查体能够帮助及早发现并有效治疗血脂异常。建议至少每半年测一次血脂 肝功能、肾功能，每半年检查一次 糖尿病肾病是糖尿病最常见的慢性并发症,是致残、致死的重要原因 2型糖尿病肾病发生率在20%，仅次于心脑血管病变 眼底检查，每半年至一年检查一次 糖尿病视网膜病变 病程五年内：眼底病变不常见 病程十年：50%眼底病变 病程20年：80-90%眼底病变 * Dneu is a common and troublesome complication of DM, leading to great morbidity and mortality.the clinical symptoms are nonspecific and insidious and progress slowly. that the risk of Coronary heart disease in patients with T2DM was was demonstrated 2 to 3 times higher compared with those without diabetes. CHD is the leading cause of mortality in patients with DM. Of all the late complications, foot problems are probably the most preventable. The patients at high risk of diabetic foot ( such as with DN and peripheral vascular disease etc) must pay close attention to their feet, this may be an issue with exercise. ( 1 in 5 people with diabetes enter the hospital due to foot problems. Usually due to poor wound healing which is caused by poor circulation. ) * out .of chronic complications, Approximately 25% of patients with T1DM have DR after 5 years, with the figure increasing to 60% and 80% after 10 and 15 years, respectively. However, there are more adult-onset cases than juvenile-onset cases, type 2 disease accounts for a higher proportion of patients with visual loss. (vision loss from DR generally results from persistent, nonclearing vitreous hemor