Home P D
Department of Medicine, University of Newcastle upon Tyne, England.
Pharmacoeconomics. 1995;8 Suppl 1:72-9. doi: 10.2165/00019053-199500081-00016.
Primary prevention of insulin-dependent diabetes mellitus (IDDM, type I diabetes) remains a research goal. Primary prevention of non-insulin-dependent diabetes mellitus (NIDDM, type II diabetes) is likely to remain part of general health education on healthy lifestyles. However, the often delayed diagnosis of type II diabetes, accompanied by early development of complications, offers opportunities for detection programmes, provided that these can overcome the hurdle of the low annual incidence of this disease. By contrast, programmes for the detection of arterial risk factors and treatable complications of previously diagnosed diabetes are well established as an integrated, and thus efficient, annual review. The results of such review guide the different forms of management programmes such as educational programmes for foot care and smoking, drug therapy for hypertension, dyslipidaemia and early nephropathy, and crisis management (laser photocoagulation) of proliferative retinopathy. Such annual review, additional to review of lifestyle and metabolic control, offers opportunities for on-going preventive education and is now the basis of quality development and needs assessment technologies.
胰岛素依赖型糖尿病（IDDM，I型糖尿病）的一级预防仍是一个研究目标。非胰岛素依赖型糖尿病（NIDDM，II型糖尿病）的一级预防可能仍将是关于健康生活方式的一般健康教育的一部分。然而，II型糖尿病常常诊断延迟，并伴有并发症的早期发生，这为检测项目提供了机会，前提是这些项目能够克服该疾病年发病率低这一障碍。相比之下，检测动脉危险因素以及已确诊糖尿病的可治疗并发症的项目，作为一种综合且高效的年度检查，已经确立。这种检查的结果指导着不同形式的管理项目，如足部护理和戒烟教育项目、高血压、血脂异常和早期肾病的药物治疗，以及增殖性视网膜病变的危机管理（激光光凝）。这种年度检查，除了对生活方式和代谢控制进行检查外，还提供了持续预防教育的机会，并且现在是质量发展和需求评估技术的基础。
