Heukamp I, Then C, Lechner A, Seissler J
Medizinische Klinik und Poliklinik IV, Diabeteszentrum, Klinikum der Universität München, Ziemssenstr. 1, 80336, München.
Internist (Berl). 2013 Feb;54(2):201-14; quiz 215-6. doi: 10.1007/s00108-012-3174-7.
Type 1a diabetes develops from a chronic autoimmune process leading to absolute insulin deficiency and proneness to ketosis. Prospective studies have clearly shown that intensive insulin therapy (ICT) results in improved quality of life and reduced development of diabetes-associated microvascular and macrovascular complications. The gold standard of therapy in type 1 diabetes is insulin injection with a basal bolus insulin regimen, in which patient daily routine and wishes are considered. The treatment goals should be determined on an individualized basis together with the patient. An HbA(1c) value < 7.0% is considered to be well controlled while values ≤ 6.5% indicate an excellent blood glucose control, as long as there are no episodes of severe hypoglycemia. As many adult patients with type 1 diabetes develop additional cardiovascular risk factors dyslipidemia and hypertension should also be considered and treated according to current treatment guidelines. A multimodal treatment may be the best way to preserve quality of life in patients with type 1 diabetes.
1型糖尿病由慢性自身免疫过程发展而来，导致绝对胰岛素缺乏并易发生酮症。前瞻性研究清楚地表明，强化胰岛素治疗（ICT）可改善生活质量，并减少糖尿病相关微血管和大血管并发症的发生。1型糖尿病的治疗金标准是采用基础-餐时胰岛素方案进行胰岛素注射，该方案会考虑患者的日常生活习惯和意愿。治疗目标应与患者一起根据个体情况确定。只要没有严重低血糖发作，糖化血红蛋白（HbA1c）值<7.0%被认为控制良好，而值≤6.5%则表明血糖控制极佳。由于许多成年1型糖尿病患者会出现其他心血管危险因素，血脂异常和高血压也应根据当前治疗指南进行评估和治疗。多模式治疗可能是维持1型糖尿病患者生活质量的最佳方法。
