美国糖尿病协会2008糖尿病诊疗指南(上)

美国糖尿病协会(ADA)多年来致力于糖尿病的诊疗标准和指南的制定与传播,相关文献发表在多种学术期刊上供相关人士阅读学习。文献中包含糖尿病诊疗中各主要要点的建议标准,同时也关注某些特定问题的解答,是目前世界最具权威的有关糖尿病诊疗标准指南之一。2008年版ADA糖尿病诊疗     

仲景消渴学说在糖尿病治疗中的运用

根据仲景消渴学说的基本特点和理论内涵,将《伤寒杂病论》有关消渴的病机整理归纳为燥热内盛、气阴双亏、阴阳并虚、水湿内停、气机郁滞、瘀血内阻、湿热蕴结七种类型,并探讨张仲景创立的清热润燥、益气养阴、调补阴阳、通阳行水、疏理气机、活血化瘀、清化湿热等治法在糖尿病治疗中的运用。认为深入系统研究仲景消渴学说,对指导目前糖尿病的治疗和挖掘有效方药具有重要意义。     

Aglycosuric Diabetes

The usefulness of urine tests for glucose was compared with that of blood sugar determinations in detecting diabetes mellitus in 2000 medical outpatients. Eighty-five patients proved to be diabetic, but 33 of these had no glycosuria on their first visit and would not have been detected by laboratory tests had the blood glucose levels not been measured. Exactly one-half of the new diabetics discovered would have been missed (15 of 30) had only urine tests been performed. The new diabetics who were aglycosuric at their initial examination had a mild form of the disease, were predominantly elderly, and were controlled, in nearly every case, by diet alone. Most of these patients had evidence of an elevated renal threshold for glucose. These results indicate that there is a large group of patients with mild, asymptomatic, diabetes mellitus who remain undetected unless blood tests are employed routinely. Because they have little or no glycosuria these patients do not have polydipsia, polyphagia, polyuria, or loss of weight. Automation in the medical laboratory has made routine blood tests for glucose feasible and rewarding in detecting diabetes mellitus.