糖尿病检验的新指南发布
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By LabMedica International staff writers Posted on 07 Mar 2018 |
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图片：FreeStyle Libre葡萄糖连续监测系统（图片蒙雅培惠赐）。
美国糖尿病协会(ADA)在其《2018年糖尿病医护标准》中推荐对血糖不达标的18岁及以上全体成人施行葡萄糖连续监测(CGM)，并筛查高风险青少年的2型糖尿病。
这份指南中的两节——糖尿病分类与诊断和血糖目标——专门解决血糖血红蛋白(A1C)测量的限制。若干不同的因子可能影响检验结果，如试剂干扰、血红蛋白变异和红细胞更新率变化以及年龄、怀孕和种族。
美国糖尿病协会位于弗吉尼亚州阿灵顿，为其工作的科学家证明，相较那些血糖不达标的糖尿病患者或疗法发生改变的糖尿病患者，成功管理其糖尿病的患者一年只做两次A1C检验。对这些患者来说，A1C检验应该一季度做一次。科学家建议：“A1C床旁检验为更及时地改变疗法提供了机会。”
ADA的2018年更新版指南还细化了对某些人群的筛查建议。例如，它建议对儿童和18岁以下的肥胖青少年做2型糖尿病筛查，他们的体重指数处于同龄同性别者的前85%，体重处于同等身高者的前85%，或体重大于同等身高理想值的120%，还有一个或多个风险因子，包括：直系或旁系亲属有2型糖尿病家族史；怀孕期间的任何糖尿病史；印第安人、非裔美国人、拉丁裔美国人或太平洋岛屿亚裔美国人的后裔；胰岛素耐受迹象或与胰岛素耐受相关的病症，如高血压或血脂异常。
2018年的标准还包括有关CGM新技术的内容，重点推介刚获得批准的“优盘”式CGM设备，由雅培公司糖尿病护理部(Alameda, CA, USA)出品，可供成人在需要时获得葡萄糖的读数。ADA还提供了其它设备信息，不再需要指血检验的确认就能做出治疗决策。最近的数据显示CGM有助于更好地控制1型糖尿病成人患者的血糖，新指南修改了一些内容以与这些数据一致。
这份指南发表于2018年1月号的《糖尿病医护标准》(Standards of Medical Care in Diabetes)杂志。作者们指出：“对严格受控的1型糖尿病成人患者的研究发现，优盘 CGM用户低血糖症的时间少于那些使用血糖器件自我监测的用户。然而，因为优盘CGM和其它CGM设备之间有显著差异，所以需要进一步讨论预后及相关的特殊建议。”
Related Links:
美国糖尿病协会
雅培公司糖尿病护理部
这份指南中的两节——糖尿病分类与诊断和血糖目标——专门解决血糖血红蛋白(A1C)测量的限制。若干不同的因子可能影响检验结果，如试剂干扰、血红蛋白变异和红细胞更新率变化以及年龄、怀孕和种族。
美国糖尿病协会位于弗吉尼亚州阿灵顿，为其工作的科学家证明，相较那些血糖不达标的糖尿病患者或疗法发生改变的糖尿病患者，成功管理其糖尿病的患者一年只做两次A1C检验。对这些患者来说，A1C检验应该一季度做一次。科学家建议：“A1C床旁检验为更及时地改变疗法提供了机会。”
ADA的2018年更新版指南还细化了对某些人群的筛查建议。例如，它建议对儿童和18岁以下的肥胖青少年做2型糖尿病筛查，他们的体重指数处于同龄同性别者的前85%，体重处于同等身高者的前85%，或体重大于同等身高理想值的120%，还有一个或多个风险因子，包括：直系或旁系亲属有2型糖尿病家族史；怀孕期间的任何糖尿病史；印第安人、非裔美国人、拉丁裔美国人或太平洋岛屿亚裔美国人的后裔；胰岛素耐受迹象或与胰岛素耐受相关的病症，如高血压或血脂异常。
2018年的标准还包括有关CGM新技术的内容，重点推介刚获得批准的“优盘”式CGM设备，由雅培公司糖尿病护理部(Alameda, CA, USA)出品，可供成人在需要时获得葡萄糖的读数。ADA还提供了其它设备信息，不再需要指血检验的确认就能做出治疗决策。最近的数据显示CGM有助于更好地控制1型糖尿病成人患者的血糖，新指南修改了一些内容以与这些数据一致。
这份指南发表于2018年1月号的《糖尿病医护标准》(Standards of Medical Care in Diabetes)杂志。作者们指出：“对严格受控的1型糖尿病成人患者的研究发现，优盘 CGM用户低血糖症的时间少于那些使用血糖器件自我监测的用户。然而，因为优盘CGM和其它CGM设备之间有显著差异，所以需要进一步讨论预后及相关的特殊建议。”
Related Links:
美国糖尿病协会
雅培公司糖尿病护理部
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