Stuart W P, Wolf B, Macaulay E M, Cross K S
Department of Vascular Surgery, Aberdeen Royal Infirmary, UK.
J R Coll Surg Edinb. 1998 Feb;43(1):11-2.
Owing to the high prevalence of diabetes mellitus in patients with peripheral arterial disease, screening for this disorder is necessary on a vascular ward. Our current practice of random plasma glucose (RPG) testing on every admission was reviewed. This test, although crude, excludes diabetes if the cutoff level is set as low as 6.0 mmol/L. A total of 36% of our patients had an abnormal result, but this was not further acted upon. A further 19% had no test result recorded at all. This practice is inadequate and has resulted in the following implementations: (1) every patient with clinical evidence of arterial disease should have their RPG level measured; (2) patients with a level > 6.0 mmol/L should have a fasting plasma glucose level estimated; and (3) patients with an abnormal fasting plasma glucose level should be referred to the diabetic clinic.
由于外周动脉疾病患者中糖尿病的高患病率，在血管病房对这种疾病进行筛查是必要的。我们回顾了目前每次入院时进行随机血糖（RPG）检测的做法。该检测虽然粗略，但如果将临界值设定为低至6.0 mmol/L，则可排除糖尿病。我们共有36%的患者结果异常，但未对此采取进一步行动。另有19%的患者根本没有记录检测结果。这种做法是不够的，因此产生了以下实施措施：（1）每例有动脉疾病临床证据的患者都应检测其RPG水平；（2）RPG水平>6.0 mmol/L的患者应测定空腹血糖水平；（3）空腹血糖水平异常的患者应转诊至糖尿病诊所。
