什麼是糖尿病前期 What is prediabetes?

 - 由Grace Tom姊妹(已退休的註冊護士)撰寫  

 - Written by Grace Tom (Retired RN) 

 

 

 

 

文章使用中英對照  Article is in both Chinese & English


什麼是糖尿病前期?

糖尿病前期是當一個人不能正常消化體內的糖份或稱空腹血糖異常

-在美國有九千萬二十歲以上的人都有糖尿病前期, 有空腹血糖高過正常, 但又未診斷為糖尿病。

-及早診斷糖尿病前期是很重要的,因為可防止有二型糖尿病的發生及防止因它所引致的併發症, 如心臟,血管, 腦, 眼及腎的疾病發生。

糖尿病前期的症狀

  1. 大多數人都沒有症狀
  2. 有時會有早期二型糖尿病的症狀, 例如有異常的口渴, 頻頻小便, 有些疲倦及眼朦。

誰應該要檢驗

  1.  四十五歲以上的人仕或長者。
  2. 過重的人, 有體重指數(BMI-25及以上)或亞州人BMI高過23, 而又有以下的風險:-
  • 不活躍
  • 直系親屬(如父母親及兄弟姊妹) 有糖尿病歷史
  • 其他有高風險族群:- 亞州人, 非裔美國人, 亞太人, 拉美裔人, 及美州印弟安人
  • 曾有妊娠糖尿病及產下超過九磅的嬰兒
  • 有多囊性卵巢疾病
  • 有高膽固醇, 高三甘油脂及低的高飽和脂肪的膽固醇
  • 有兩次或多次不正常的高血糖檢驗報告
  • 有心臟病的歷史

 

怎樣診斷糖尿病前期?

您的家庭醫生會檢驗以下其中不同的血檢驗:-

1. 空肚驗血糖 -正常-70-99mg/dl(3.88-5.5mmol/L)

    糖尿病前期-100mg-125mg/dl (5.55-6.94mmol/L)

    糖尿病-空肚血糖度數-兩次或多次保持高過正常度數

2. 糖耐量異常度數-OGTT-(Oral Glucose Tolerance Test)

     正常-低過140mg/dl (7.8mmol/L)

     糖尿病前期-由140-199mg/dl (7.8 to 11.1mmol/L)

     糖尿病-高過200mg/L (11.11mmol/L)

3.  糖化血紅素(Hgb A1c) 

     正常5.7%或低過5.7%

     糖尿病前期-5.7%至6.4%

     糖尿病-6.5% 或高過6.5%

若您有兩次或以上的空肚血糖檢驗是在126mg/dl  您的醫生便會通知您患有糖尿病。

為什麼察覺及治療糖尿病前期是那麽重要呢?

-注意糖尿病前期的象徵, 在診斷有糖尿病之前可防止有二型糖尿病及可降低有糖尿病併發症的風險, 如心臓病, 腎及眼疾病, 腸胃病, 神經組織疾病, 及中風。  

研究報告顯示,防止糖尿病的計劃, 可助於防止有糖尿病的發生, 並提供以下的建議:-

  • 健康生活的改變
  • 飲食的改變
  • 體力活動-每天做三十分鐘適度的運動
  • 若您過重-減低4-7%的體重-便可降低糖尿病的機率60%

糖尿病前期的處理

  1. 每星期做五日運動, 每一次三十分鐘, 可分三次10分鐘。步行是最好的運動。在未開始運動計劃之前, 請教您的醫生。
  2. 停止吸煙。若您從未吸過煙, 請不開始。
  3. 聽從您醫生的建議-醫治高血壓, 高膽固朜, 及高三甘油脂。
  4. 若過重-減 5-10%體重, 可有很大的分別。
  5. 健康飲食。若有須要-請教營養師。及學習閱讀食物標籤, 防止進食有高糖份的食物及飲品。
  6. 若您有糖尿病前期的症狀, 請盡快請教您的家庭醫生。
  7. 學習最新的糖尿病及糖尿病前期的知識(閱讀醫學刊物,參加糖尿病會議及與專業人仕傾談)。
  8. 若有疑問- 請教專業人仕任何有關糖尿病的問題。

 

What is prediabetes?

Prediabetes is a condition when one has impaired glucose tolerance or 

-Impaired fasting blood glucose – a health condition that has no symptoms.

-About 90 millions people in the U.S. over 20 years old have prediabetes, with fasting blood glucose higher than normal, but are not high enough to be classified as diabetes.

-Early diagnosis of prediabetes is important, and may prevent type 2 diabetes as well as complications, such as heart and blood vessels diseases, eye and kidney diseases.

Symptoms of Prediabetes

  1. Most people have no symptoms.
  2. Early signs of diabetes mellitus e.g. unusual thirst, frequent urination, a little fatigue, and blurred vision.

Who should get tested?

  1. 45 years of age or older.
  2. Overweight people with a BMI ( Body Mass Index ) of 25 or 23 for Asian, and have the following risk factors:-
  • Physically inactive
  • First degree relative with Diabetes, e.g. parents, and siblings.
  • High risk ethnic groups:- Asian, African American, Asian Pacific Islander, Hispanic, and American Indian.
  • History of gestational diabetes or delivered an over 9 pounds baby.
  • Ovarian Polycystic Syndrome.
  • High cholesterol, high triglycerides, or low HDL(good) cholesterol.                
  • Abnormal blood glucose tests in the past or on 2 occasions.
  • History of heart disease.

How is Prediabetes diagnosed?

Your family doctor will perform one of the three different blood tests:-

1. Fasting blood glucose (FBG)-normal – 70-99mg/dl(3.88-5.5mmol/L)

    Prediabetes-100mg-125mg/dl( 5.55-6.94mmol/L)

2. Oral Glucose Tolerance Test (OGTT)-normal-less than 140mg/dl (7.8mmol/L)

     Prediabetes-from 140-199mg/dl (7.8 to 11.1mmol/L)

3. Hemoglobin A1c ( average 3 months BG ) test-

     Normal- 5.6% or less

     Prediabetes – 5.7% to 6.4%

     Diabetes – 6.5% or higher

If Fasting Blood Glucose is 126mg/dl or greater on 2 or more tests then your doctor may notify you that you have diabetes.

Why is it so important to recognize and treat Prediabetes?

-Identify the signs of prediabetes before diabetes is diagnosed can prevent Type 2 diabetes and lower risk of diabetic complications e.g. heart diseases, kidney and eye diseases, stomach and bowel diseases, nerve endings diseases, and stroke.

Research study shows Diabetes Prevention Program (DPP) can prevent diabetes to happen by the following recommendations:-

  • Healthy life changes
  • Diet changes
  • Physical activity-30 minutes of moderate physical activity per day
  • 4-7% of weight loss if you are overweight –can help in 60% reduction in Diabetes Mellitus

Treatment of Prediabetes

  1. Exercise 30 minutes -5 days a week, can be 3 sessions of 10 minutes. Walking is the best exercise-check with your doctor before starting any exercise program.
  2. Stop smoking, and do not start if you have not been smoking.
  3. Treat high blood pressure, high cholesterol and high triglycerides per your doctor’s advices.
  4. Lose weight 5-10%, can make a big difference.
  5. Eat a healthy diet. Consult a dietitian if needed.  And learn to read food labels to avoid high glucose food and drinks.
  6. Consult your primary care physician as soon as possible when you have signs and symptoms of prediabetes.
  7. Educate yourself with updated diabetic and prediabetic knowledge,(reading medical journals, attending diabetic conferences and talking to professionals ).
  8. Be your own advocate. Consult professionals on any diabetic questions.

 


預防勝於治療  wink

Prevention is better than cure  wink

 

 
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