Winkler G, Simon K, Tóth J, Gyulai M
Fövárosi Szent János Kórház I. Belosztály, Budapest.
Orv Hetil. 1997 Apr 27;138(17):1043-51.
Medical opinion about the significance of non-insulin-dependent diabetes has been recently changed for three reasons: epidemiological evidence about the continuously increasing disease-prevalence, accumulation of new intriguing details on the pathophysiology of the disease, and the growing clinical evidence about the importance of accelerated atheromatosis related to any stage of the disease. The new theoretical approach resulted in some new aspects of therapeutical management as well. There is an emphasis on the early recognition, the very strict metabolic control and the individualized form of the therapy. Well organized regular medical care for the diabetics, recognition and effective treatment of comorbidities (dyslipidemia, high blood pressure), self-involvement of the patients in the management (ie. patient education) are the corner stones of this approach. The authors give a short review about the armamentura of the therapy available nowadays, including rules of indication for different sulfonylurea drugs, combined sulfonylurea-insulin treatment and single insulin regimes as well.
关于非胰岛素依赖型糖尿病的重要性,医学观点近来发生了变化,原因有三点:关于该疾病患病率持续上升的流行病学证据、该疾病病理生理学方面新的有趣细节的积累,以及关于与该疾病任何阶段相关的加速动脉粥样硬化重要性的临床证据不断增加。新的理论方法也导致了治疗管理的一些新方面。重点在于早期识别、非常严格的代谢控制以及个性化的治疗形式。为糖尿病患者提供组织良好的定期医疗护理、识别并有效治疗合并症(血脂异常、高血压)、患者自身参与管理(即患者教育)是这种方法的基石。作者对目前可用的治疗手段进行了简要综述,包括不同磺脲类药物的适应证规则、磺脲类药物与胰岛素联合治疗以及单一胰岛素治疗方案。