2型糖尿病全球防治指南新特点.pptVIP

每年全面检测一次 检测原则及目的 General principles include: annual review of control and complications; an agreed and continually updated diabetes care plan; and involvement of the multidisciplinary team in delivering that plan, centred around the person with diabetes. 临床血糖监测方法 HbA1c performed every 2 to 6 months depending on level and stability of blood glucose control,and change in therapy. Site-of-care capillary plasma glucose monitoring at random times of day is not generally recommended. 自我血糖监测方法 Self-monitoring of blood glucose (SMBG) should be available to those; For all newly diagnosed people with Type 2 diabetes; those on insulin treatment; to provide information on hypoglycaemia; to assess glucose excursions due to medications and lifestyle changes to monitor changes during intercurrent illness. SMBG can be considered in relation to: outcomes (a decrease in HbA1c with the ultimate aim of decreasing risk of complications) safety (identifying hypoglycaemia) process (education, self-empowerment, changes in therapy). 对尿糖监测的评价 Urine glucose testing is cheap but has limitations. Urine free of glucose is an indication that the blood glucose level is below the renal threshold, which usually corresponds to a blood glucose level of about 10.0 mmol/l (180 mg/dl). Positive results do not distinguish between moderately and grossly elevated levels, and a negative result does not distinguish between normoglycaemia and hypoglycaemia. 4.治疗概论 生活方式干预治疗 目的：通过调整生活方式，如饮食、运动等更好地控制血糖、血压、血脂等危险因素。 关于饮食； 专家指导下制定个体营养需求方案; 严格限制高热量、高脂食物、食盐及酒精等； 根据降糖药（口服药及胰岛素）及运动量调整饮食量。 关于运动： Encourage increased duration and frequency of physical activity (where needed), up to 30-45 minutes on 3-5 days per week, or an accumulation of 150 minutes of physical activity per week. 生活方式干预治疗利益 Randomized controlled trials and outcome studies of medical nutrition therapy (MNT) in the management of Type 2 diabetes have reported improved glycaemic outcomes (HbA1c decreases of 1.0-2.0 %, depending on the ra