问题库/身体与体检
体检说血糖偏高,还没到糖尿病要紧吗
去查一次空腹血糖和糖化血红蛋白,别只测一次手指血。血糖偏高还没到糖尿病,靠少吃、减重、多动能把糖尿病往后推三到六成。查出来正常也每三年再查一次。
这里不保证什么
手指血糖不能拿来确诊。已经口渴、多尿、体重掉得快的,别再等三个月复查,尽快去内分泌科。
展开看依据2 条 · 点标题进原条目
35 岁以后只要超重,就去查一次空腹血糖,正常也每三年再查
花几十块抽一管血,就能在一点症状都没有的时候查出糖尿病前期。美国官方的筛查建议是:35 到 70 岁、超重或肥胖的人去查。查出来正常的,每三年再查一次。美国按体重指数 25 算超重,对亚裔降到 23,中国标准是 24 就算超重。
- 先算一次体重指数,体重除以身高的平方,24 以上就该查
- 空腹去抽一管血查空腹血糖,条件允许再加一个糖化血红蛋白
- 结果正常就每三年再查一次,把日期写进手机日历
坑查出糖尿病前期不等于要吃药:少吃、多动、减点体重,得糖尿病的风险能低三到六成。
成本:空腹血糖十几元。糖化血红蛋白几十元。去医院抽一次血就行。第 1 节 · 不要早死
出处
US Preventive Services Task Force (2021). Screening for Prediabetes and Type 2 Diabetes. <https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-for-prediabetes-and-type-2-diabetes>:「at a lower BMI (≥23) if the patient is Asian American」;国家卫生健康委办公厅 (2024). 居民体重管理核心知识(2024 年版)释义:「根据《成年人体重判定》(WS/T 428-2013)行业标准……24.0≤BMI<28.0 为超重,BMI≥28.0 为肥胖」. <https://www.gov.cn/zhengce/zhengceku/202407/P020240703481519509521.pdf>;Wang L 等 (2021). Prevalence and Treatment of Diabetes in China, 2013-2018. JAMA:「In 2018, among adults with diabetes, 36.7% (95% CI, 34.7%-38.6%) reported being aware of their condition」「These rates did not change significantly from 2013.」<https://doi.org/10.1001/jama.2021.22208>
查出糖尿病前期(血糖偏高、还没到糖尿病),就靠少吃、减重、多动把糖尿病往后推,每半年复查一次血糖
血糖偏高、还没到糖尿病的人,少吃、多动、减掉一点体重,得糖尿病的风险能低三到六成。中国大庆的试验跟了 30 年,这么做的人死亡的概率低约四分之一,平均多活约一年半。但美国和芬兰的同类试验没看出死亡率有差别。
- 半年抽一次血复查空腹血糖,把每次的数记在一个地方
- 每天比原来少吃 400 到 500 千卡,先停掉甜饮料
- 每周快走这类中等强度活动凑够 150 分钟,体重减一点
坑这一条有争议:推迟糖尿病是确定的,延寿还没有定论,只有大庆试验看到少死人,美国和芬兰的同类试验没看出差别。
成本:不花钱,少吃还能省一点。每周快走这类中等强度活动至少 150 分钟,摊到每天二十来分钟。每天比原来少吃 400 到 500 千卡。难在要一直坚持,体重减下来以后还要维持住。每半年抽一次血复查,空腹血糖十几元。第 2 节 · 不要慢慢死
出处
Pan XR, Li GW, Hu YH, 等 (1997). Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care, 20(4), 537-544. <https://doi.org/10.2337/diacare.20.4.537>;Li G, Zhang P, Wang J, 等 (2014). Cardiovascular mortality, all-cause mortality, and diabetes incidence after lifestyle intervention for people with impaired glucose tolerance in the Da Qing Diabetes Prevention Study: a 23-year follow-up study. Lancet Diabetes & Endocrinology, 2(6), 474-480. <https://doi.org/10.1016/S2213-8587(14)70057-9>;Gong Q, Zhang P, Wang J, 等 (2019). Morbidity and mortality after lifestyle intervention for people with impaired glucose tolerance: 30-year results of the Da Qing Diabetes Prevention Outcome Study. Lancet Diabetes & Endocrinology, 7(6), 452-461. <https://doi.org/10.1016/S2213-8587(19)30093-2>;Knowler WC, Barrett-Connor E, Fowler SE, 等 (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. NEJM, 346(6), 393-403. <https://doi.org/10.1056/NEJMoa012512>;Diabetes Prevention Program Research Group (2015). Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up: the Diabetes Prevention Program Outcomes Study. Lancet Diabetes & Endocrinology, 3(11), 866-875. <https://doi.org/10.1016/S2213-8587(15)00291-0>;Lee CG, Heckman-Stoddard B, Dabelea D, 等 (2021). Effect of Metformin and Lifestyle Interventions on Mortality in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study. Diabetes Care, 44(12), 2775-2782. <https://doi.org/10.2337/dc21-1046>(争议方);Tuomilehto J, Lindström J, Eriksson JG, 等 (2001). Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. NEJM, 344(18), 1343-1350. <https://doi.org/10.1056/NEJM200105033441801>;Lindström J, Ilanne-Parikka P, Peltonen M, 等 (2006). Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study. Lancet, 368(9548), 1673-1679. <https://doi.org/10.1016/S0140-6736(06)69701-8>;Uusitupa M, Peltonen M, Lindström J, 等 (2009). Ten-year mortality and cardiovascular morbidity in the Finnish Diabetes Prevention Study—secondary analysis of the randomized trial. PLoS ONE, 4(5), e5656. <https://doi.org/10.1371/journal.pone.0005656>(争议方);健康中国行动推进委员会 (2019). 健康中国行动(2019—2030年),(十四)糖尿病防治行动(湖南省卫生健康委员会转载). <https://wjw.hunan.gov.cn/wjw/ztzl/knowledge/tzggzcfg/202003/t20200303_11359594.html>
同类问题
这条回答是给一个正在着急的人写的,不是法律意见或医嘱。 金额大、动到人身、或者已经进到程序里,去找律师、医生和办事窗口。