Hanefeld M, Köhler C
Zentrum für Klinische Studien, Forschungsbereich Stoffwechsel und Endokrinologie, Dresden.
MMW Fortschr Med. 2004 Sep 2;146(35-36):28-9, 31.
For each known diabetic at least one new patient is diagnosed when the 75-g OGTT is used for screening. For early diagnosis in high risk groups, the oral glucose tolerance test is indispensable since ca. 30% of the asymptomatic diabetes cases are identified on the basis of a 2-hour postchallenge glucose value of > 11.1 mmol/l. In controlled studies on persons with IGT, every second diabetes case could be prevented through lifestyle modifications beginning in childhood. Three-year studies showed that the incidence of diabetes could be reduced by about one-third with the medications acarbose, metformin and orlistat. The observation that statins, ACE inhibitors and AT1 blockers also contributed to a reduction of new diabetes cases was made in studies on the prevention of coronary heart diseases.
当采用75克口服葡萄糖耐量试验(OGTT)进行筛查时,每发现一名已知糖尿病患者,至少会诊断出一例新患者。对于高危人群的早期诊断,口服葡萄糖耐量试验必不可少,因为约30%的无症状糖尿病病例是根据服糖后2小时血糖值>11.1 mmol/l确诊的。在针对糖耐量受损(IGT)人群的对照研究中,从儿童期开始进行生活方式干预可预防约一半的糖尿病病例。为期三年的研究表明,使用阿卡波糖、二甲双胍和奥利司他等药物可使糖尿病发病率降低约三分之一。在冠心病预防研究中发现,他汀类药物、血管紧张素转换酶(ACE)抑制剂和血管紧张素Ⅱ1型受体(AT1)阻滞剂也有助于减少新糖尿病病例的发生。