Jain Sunil
Department of Paediatrics, Indian Armed Forces Medical Services, c/o 56 APO 900244, India.
World J Clin Pediatr. 2024 Mar 9;13(1):89201. doi: 10.5409/wjcp.v13.i1.89201.
Diabetes is a devastating public health problem. Prediabetes is an intermediate stage in the disease processes leading to diabetes, including types 1 and 2 diabetes. In the article "Prediabetes in children and adolescents: An updated review," the authors presented current evidence. We simplify and systematically clearly present the evidence and rationale for a conceptual framework we term the '3ASs': (1) Awareness Sensible; (2) Algorithm Simple; and (3) Appealing Strategies. Policy makers and the public need to be alerted. The prevalence of prediabetes should send alarm bells ringing for parents, individuals, clinicians, and policy makers. Prediabetes is defined by the following criteria: impaired fasting glucose (100-125 mg/dL); impaired glucose tolerance (2 h postprandial glucose 140-199 mg/dL); or hemoglobin A1c values of 5.7%-6.4%. Any of the above positive test alerts for intervention. Clinical guidelines do not recommend prioritizing one test over the others for evaluation. Decisions should be made on the strengths and shortfalls of each test. Patient preferences and test accessibility should be taken into consideration. An algorithm based on age, physiological stage, health status, and risk factors is provided. Primordial prevention targeting populations aims to eliminate risk factors through public education and encouraging practices through environmental modifications. Access to healthy foods is provided. Primary prevention is for individuals with a prediabetes diagnosis and involves a structured program to reduce body weight and increase physical activity along with a healthy diet. An overall methodical move to a healthy lifestyle for lifelong health is urgently needed. Early energetic prediabetes action is necessary.
糖尿病是一个极具破坏性的公共卫生问题。糖尿病前期是导致糖尿病(包括1型和2型糖尿病)的疾病进程中的一个中间阶段。在《儿童和青少年糖尿病前期:最新综述》一文中,作者展示了当前的证据。我们简化并系统清晰地呈现了一个概念框架的证据和基本原理,我们将其称为“3ASs”:(1)明智的认知;(2)简单的算法;(3)有吸引力的策略。政策制定者和公众需要得到警示。糖尿病前期的患病率应该为家长、个人、临床医生和政策制定者敲响警钟。糖尿病前期由以下标准定义:空腹血糖受损(100 - 125毫克/分升);糖耐量受损(餐后2小时血糖140 - 199毫克/分升);或糖化血红蛋白值为5.7% - 6.4%。上述任何一项阳性检测结果都提示需要进行干预。临床指南不建议在评估时优先选择一种检测方法而忽视其他方法。应根据每种检测方法的优缺点来做出决策。应考虑患者的偏好和检测的可及性。提供了一种基于年龄、生理阶段、健康状况和风险因素的算法。针对人群的一级预防旨在通过公共教育消除风险因素,并通过环境改造鼓励相关行为。提供获取健康食品的途径。二级预防针对已诊断为糖尿病前期的个体,包括一个结构化的项目,以减轻体重、增加身体活动并搭配健康饮食。迫切需要全面、有条不紊地转向健康的生活方式以实现终身健康。早期积极应对糖尿病前期至关重要。