Shane-McWhorter Laura
Department of Pharmacotherapy, University of Utah College of Pharmacy, Salt Lake City, Utah 84112, USA.
Consult Pharm. 2010 Jun;25 Suppl B:11-8.
Prediabetes encompasses a variety of abnormalities, including impaired fasting glucose, impaired glucose tolerance, and metabolic syndrome. Prediabetes also increases the risk of developing type 2 diabetes mellitus (T2DM) by 3- to 10-fold, but the complications associated with hyperglycemia begin early in the patient's progression from normal glucose levels to diabetes. Early identification and treatment of prediabetes has the potential to reduce or delay progression to overt diabetes, to preempt related cardiovascular and microvascular disease, and to significantly improve morbidity and mortality. This clinical review provides a vehicle to examine management of prediabetes in patients 65 years of age and older, including diagnostic criteria and recommendations for management.
Live symposium presentation based on clinical practice and research, medical literature, and studies published between May 1999 and March 2010 on managing diabetes in older adults, government statistics, and medical society guidelines.
Effective prediabetes management is important to reducing the risk of progression to T2DM. Recommended first-line therapy is lifestyle modification that may include exercise, nutritional therapy, and weight loss. Pharmacological therapies, when indicated, can aid in improving glucose, blood pressure, and lipid parameters in this patient subgroup.
糖尿病前期包括多种异常情况，如空腹血糖受损、糖耐量受损和代谢综合征。糖尿病前期还会使患2型糖尿病（T2DM）的风险增加3至10倍，但是与高血糖相关的并发症在患者从正常血糖水平发展为糖尿病的过程中很早就开始出现了。早期识别和治疗糖尿病前期有可能降低或延缓向显性糖尿病的进展，预防相关的心血管和微血管疾病，并显著改善发病率和死亡率。本临床综述提供了一个契机，来探讨65岁及以上患者糖尿病前期的管理，包括诊断标准和管理建议。
基于临床实践和研究的现场研讨会报告、医学文献、1999年5月至2010年3月期间发表的关于老年人糖尿病管理的研究、政府统计数据以及医学协会指南。
有效的糖尿病前期管理对于降低进展为T2DM的风险很重要。推荐的一线治疗方法是生活方式改变，可能包括运动、营养治疗和减肥。如有必要，药物治疗有助于改善该患者亚组的血糖、血压和血脂参数。
