Diabetes Metab Res Rev. 2010 Jan;26(1):7-9. doi: 10.1002/dmrr.1039.
The risk associated with progression to diabetes as well as for cardiovascular complications increases along a continuum, rather than being threshold-dependent. How can we identify those with glucose levels in the upper reaches of normal who are most in need of a preventive intervention? With present criteria, we are likely excluding many individuals who have heightened risk. We introduce here the possibility of using a "personalized" glucose profile to encourage early intervention in subjects in whom glucose metabolism is deteriorating (on an individual level) but not yet abnormal on a population-based norm. We further suggest that "personalized profiles" of hemoglobin A1c and basal plasma insulin may also help encourage appropriately early intervention. That the first line therapies are so effective, safe and simple make these more sensitive approaches very attractive.
与进展为糖尿病以及心血管并发症相关的风险呈连续变化，而不是取决于阈值。我们如何识别那些血糖处于正常上限的人群中最需要预防干预的人？根据目前的标准，我们可能排除了许多风险较高的个体。我们在这里提出了使用“个性化”血糖谱的可能性，以鼓励那些血糖代谢正在恶化（在个体层面上）但尚未超出基于人群的正常范围的个体进行早期干预。我们进一步建议，血红蛋白 A1c 和基础血浆胰岛素的“个性化谱”也可能有助于鼓励适当的早期干预。一线治疗方法如此有效、安全且简单，这使得这些更敏感的方法非常有吸引力。
