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糖尿病前期筛查:在老年时期益处存疑。

Prediabetes screening: Questionable benefits in the golden years.

作者信息

Tsilingiris Dimitrios, Vallianou Natalia G, Dalamaga Maria

机构信息

First Department of Propaedeutic Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Laiko General Hospital, 17 St Thomas Street, 11527, Athens, Greece.

First Department of Internal Medicine, Evangelismos General Hospital, 45-47 Ipsilantou Str, 10676, Athens, Greece.

出版信息

Metabol Open. 2021 Apr 7;10:100091. doi: 10.1016/j.metop.2021.100091. eCollection 2021 Jun.

Abstract

Irrespective of the definition and diagnostic criteria used, the term prediabetes denotes a state of dysmetabolism with a high risk of progression to diabetes mellitus. Although diabetes-related complications may already be evident among individuals with prediabetes, interventions at this stage primarily aim to hinder the development of overt hyperglycemia rather than to prevent complications. Current recommendations for prediabetes testing are common across all adult age categories. Recent evidence arising from the prospective investigation of the natural course of prediabetes among elderly individuals pose questions regarding the benefits of meticulous prediabetes screening in this age group. In view of this and due to the lack of sufficient data to concretely support a positive impact of further preventive strategies among older individuals, screening recommendations should be reevaluated to target selected elderly individuals who are most likely to benefit in terms of quality of life and prognosis. Further therapeutic measures should be tailored to the inherent features of this frail age group, in order to exert a meaningful effect on overall health status.

摘要

无论使用何种定义和诊断标准,“糖尿病前期”一词均指代谢紊乱状态,具有进展为糖尿病的高风险。尽管糖尿病相关并发症在糖尿病前期个体中可能已很明显,但此阶段的干预主要旨在阻碍明显高血糖的发展,而非预防并发症。目前针对糖尿病前期检测的建议在所有成年年龄组中都是常见的。近期对老年人糖尿病前期自然病程进行前瞻性调查所产生的证据,对该年龄组进行细致的糖尿病前期筛查的益处提出了疑问。鉴于此,且由于缺乏足够数据来具体支持进一步预防策略对老年人产生积极影响,筛查建议应重新评估,以针对那些在生活质量和预后方面最可能受益的特定老年个体。进一步的治疗措施应根据这个脆弱年龄组的固有特征进行调整,以便对整体健康状况产生有意义的影响。

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