Fonseca V, Munshi M, Merin L M, Bradford J D
Department of Medicine, University of Arkansas for Medical Sciences, Little Rock 72205, USA.
South Med J. 1996 Sep;89(9):839-50.
Hyperglycemia can result in key biochemical reactions that may contribute to thickening of basement membranes, dysfunction of pericytes and endothelial cells, and closure of retinal vessels. The Diabetes Control and Complications Trial has proved the value of good glycemic control in preventing retinopathy and/or delaying its progression. The primary care physician has a crucial role in translating these results into practice. Recognition and management of other risk factors, such as proteinuria, smoking, and hypertension, are easily done in the primary care setting. Also, appropriate referral to an ophthalmologist for retinal evaluation and treatment is both necessary and cost effective in reducing the burden of this devastating complication of diabetes.
高血糖会引发关键的生化反应，这些反应可能导致基底膜增厚、周细胞和内皮细胞功能障碍以及视网膜血管闭塞。糖尿病控制与并发症试验已证明良好的血糖控制在预防视网膜病变和/或延缓其进展方面的价值。初级保健医生在将这些结果转化为实际行动中起着关键作用。在初级保健环境中，识别和管理其他风险因素，如蛋白尿、吸烟和高血压，很容易做到。此外，适当地转诊至眼科医生进行视网膜评估和治疗，对于减轻糖尿病这种毁灭性并发症的负担既必要又具有成本效益。
