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检测未确诊的2型糖尿病:家族史作为一种风险因素和筛查工具。

Detecting undiagnosed type 2 diabetes: family history as a risk factor and screening tool.

作者信息

Valdez Rodolfo

机构信息

Office of Public Health Genomics, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.

出版信息

J Diabetes Sci Technol. 2009 Jul 1;3(4):722-6. doi: 10.1177/193229680900300417.

Abstract

A family history of diabetes is a major risk factor for the disease. As such, it is often included in a variety of tools designed to detect either people at risk of diabetes or people with undiagnosed diabetes. One of the reasons to screen for diabetes is that it has a prolonged asymptomatic phase, which includes impaired fasting glucose, impaired glucose tolerance, and the early stages of diabetes. In terms of prevalence, diabetes is a major public health problem. Evidence shows that the detection of impaired glucose metabolism in its early stages (prediabetes) could lead to the delay or prevention of the disease and its complications. However, the issue of using family history to screen for diabetes must be discussed within the context of screening for diabetes in general. Screening for a disease among asymptomatic people must meet a series of stringent requirements to ensure the best possible outcomes. Screening for diabetes meets most of these requirements but the ones it does not meet are still important. Therefore, based on systematically collected evidence or simply by consensus among scientists, influential organizations recommend screening only among high-risk individuals. As a result, researchers have developed a variety of simple tools to identify high-risk individuals for diabetes in populations. Family history is included as a key variable in the vast majority of them. This article is a brief overview of the reasons to screen for diabetes in general, the tools available for conducting this screening, and the role of family history in these tools.

摘要

糖尿病家族史是该疾病的主要风险因素。因此,它常常被纳入各种旨在检测糖尿病高危人群或未确诊糖尿病患者的工具中。筛查糖尿病的原因之一是其存在较长的无症状期,其中包括空腹血糖受损、糖耐量受损以及糖尿病早期阶段。就患病率而言,糖尿病是一个重大的公共卫生问题。有证据表明,在早期阶段(糖尿病前期)检测到糖代谢受损可能会延缓或预防该疾病及其并发症。然而,利用家族史筛查糖尿病的问题必须在总体糖尿病筛查的背景下进行讨论。在无症状人群中筛查疾病必须满足一系列严格要求,以确保获得尽可能好的结果。糖尿病筛查满足了其中大部分要求,但未满足的那些要求仍然很重要。因此,基于系统收集的证据或仅仅是科学家之间的共识,有影响力的组织建议仅在高危个体中进行筛查。结果,研究人员开发了各种简单工具来识别人群中的糖尿病高危个体。在绝大多数此类工具中,家族史都被列为关键变量。本文简要概述了总体上筛查糖尿病的原因、用于进行此项筛查的工具以及家族史在这些工具中的作用。

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