循证医学对糖尿病诊断的贡献及目前存在的分歧

主要根据几项探讨负荷后血糖水平与糖尿病特征性视网膜病变发生率之间关系的前瞻性流行病学研究，美国国家糖尿病数据组（NDDG）/世界卫生组织（WHO）（1979/1980）提出了以口服葡萄糖耐量试验（OGTT）2h血糖水平作为糖尿病诊断的依据。得到全球的公认。美国糖尿病学会（ADA）/WHO（1997/1999）根据20世纪80年代初以后多项OGTT2h血糖与空腹血糖（FPG）水平之间相互关系的流行病学研究，将糖尿病FPG诊断标准下调至7.0mmol/L，但对是否应用OGTT于糖尿病的诊断存在分歧，有待更多的循证医学研究予以解决。

Contribution of evidence-based medicine to the diagnosis of diabetes and existing disaccord

Based on prospective epidemiologi ca l studies concerning the relationship between glycemic values during oral glucos e tolerance test (OGTT) and the incidence of diabetic retionpathy, the diagnosti c criteria recommended by National Diabetes Data Group (NDDG)/World Health Organ ization (WHO) (1979/1980) have been worldwidely accepted as the uniform diagnosi s for diabetes mellitus.According to the epidemiological data accumulated since the early eighties of the 20th century on the inter-relationship between the le vels of fasting plasma glucose (FPG) and OGTT 2 hour glycemic values, American D iabetes Association (ADA)/WHO (1997/1999) recommended the diagnostic FPG be decr eased to 7.0 mmol/L, but disaccord exists with regard to the use of OGTT for the diagnosis of diabetes. Further evidence-based medical studies are needed to so lve this problem.