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糖尿病
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== 糖尿病的诊断 == 糖尿病的诊断依赖血糖水平的测定和糖化血红蛋白检测等客观指标。存在典型高血糖症状时,只要随机一次血浆葡萄糖水平≥11.1 mmol/L(200 mg/dL)即可诊断为糖尿病 (全民健康生活方式行动)。在无明显症状时,一般需要不同日两次检测血糖达标才能确诊。临床诊断标准包括空腹、餐后血糖或糖化血红蛋白达到以下阈值(下述任一指标符合即可确诊) (全民健康生活方式行动) (2 型糖尿病 - 诊断与治疗 - 妙佑医疗国际): * '''空腹血浆葡萄糖(FPG)''' ≥7.0 mmol/L(126 mg/dL) (全民健康生活方式行动) * '''口服葡萄糖耐量试验(OGTT)2小时血浆葡萄糖''' ≥11.1 mmol/L(200 mg/dL) (全民健康生活方式行动) * '''糖化血红蛋白(HbA1c)''' ≥6.5%(48 mmol/mol) (2 型糖尿病 - 诊断与治疗 - 妙佑医疗国际) 如患者出现经典的“三多一少”等高血糖症状,以上任意一项指标达到诊断标准即可确诊糖尿病 (全民健康生活方式行动);对于无症状患者,则需在另一日复查同一指标以确认结果 (2 型糖尿病 - 诊断与治疗 - 妙佑医疗国际)。此外,当血糖水平高于正常但尚未达到上述诊断标准时,被称为糖尿病前期:例如空腹血糖在5.6~6.9 mmol/L之间,或OGTT 2小时血糖在7.8~11.0 mmol/L之间,或HbA1c在5.7%~6.4%之间,均提示存在糖耐量受损 (2 型糖尿病 - 诊断与治疗 - 妙佑医疗国际) (2 型糖尿病 - 诊断与治疗 - 妙佑医疗国际)。糖尿病前期人群发展为糖尿病的风险较高,需要积极干预和随访。常用的糖尿病检测方法包括指尖血糖快速测定(用于初步筛查)、静脉血浆血糖检测以及HbA1c测定。其中HbA1c反映的是过去2~3个月的平均血糖水平 (2 型糖尿病 - 诊断与治疗 - 妙佑医疗国际);而OGTT通过口服75克葡萄糖后监测2小时血糖反应,用于评估机体糖代谢调节能力,是诊断妊娠期糖尿病和糖耐量减低的重要方法。
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