Mata-Cases M, Artola S, Escalada J, Ezkurra-Loyola P, Ferrer-García J C, Fornos J A, Girbés J, Rica I
Semergen. 2015 Jul-Aug;41(5):266-78. doi: 10.1016/j.semerg.2014.12.001. Epub 2015 Mar 6.
In Spain, according to the Di@bet.es study, 13.8% of the adult population suffers from diabetes and 14.8% from some form of prediabetes (impaired glucose tolerance, impaired fasting glucose or both). Since early detection of prediabetes can facilitate the implementation of therapeutic measures to prevent its progression to diabetes, we believe that preventive strategies in primary care and specialized clinical settings should be agreed. Screening for diabetes and prediabetes using a specific questionnaire (FINDRISC) and/or the measurement of fasting plasma glucose in high risk patients leads to detecting patients at risk of developing diabetes and it is necessary to consider how they should be managed. The intervention in lifestyle can reduce the progression to diabetes and reverse a prediabetic state to normal and is a cost-effective intervention. Some drugs, such as metformin, have also been shown effective in reducing the progression to diabetes but are not superior to non-pharmacological interventions. Finally, an improvement in some cardiovascular risk factors has been observed although there is no strong evidence supporting the effectiveness of screening in terms of morbility and mortality. The Consensus and Clinical Guidelines Working Group of the Spanish Diabetes Society has issued some recommendations that have been agreed by the Sociedad Española de Endocrinología y Nutrición, Sociedad Española de Endocrinología Pediátrica, Sociedad Española de Farmacia Comunitaria, Sociedad Española de Medicina Familiar y Comunitaria, Sociedad Española de Médicos Generales, Sociedad Española de Médicos de Atención Primaria, Sociedad Española de Medicina Interna, Asociación de Enfermería Comunitaria and Red de Grupos de Estudio de la Diabetes en Atención Primaria.
在西班牙，根据Di@bet.es研究，13.8%的成年人口患有糖尿病，14.8%患有某种形式的糖尿病前期（糖耐量受损、空腹血糖受损或两者皆有）。由于早期发现糖尿病前期有助于实施预防其进展为糖尿病的治疗措施，我们认为在初级保健和专科临床环境中的预防策略应该达成共识。使用特定问卷（芬兰糖尿病风险评分问卷）和/或测量高危患者的空腹血糖来筛查糖尿病和糖尿病前期，能够检测出有患糖尿病风险的患者，有必要考虑如何对他们进行管理。生活方式干预可以降低进展为糖尿病的风险，并使糖尿病前期状态逆转至正常，且是一种具有成本效益的干预措施。一些药物，如二甲双胍，也已被证明在降低进展为糖尿病的风险方面有效，但并不优于非药物干预。最后，尽管没有强有力的证据支持筛查在发病率和死亡率方面的有效性，但已观察到一些心血管危险因素有所改善。西班牙糖尿病协会的共识与临床指南工作组发布了一些建议，这些建议已得到西班牙内分泌与营养学会、西班牙儿内分泌学会、西班牙社区药房协会、西班牙家庭与社区医学学会、西班牙全科医生协会、西班牙初级保健医生协会、西班牙内科医学学会、社区护理协会以及初级保健糖尿病研究小组网络的认可。
