{"countAll":0,"orderType":null,"readLevel":"0","lyTopicReq":{"id":"1935","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":null,"content":null,"barId":"1935","topicTypeId":null,"topicThemeId":"1029","readLevel":0,"files":null,"clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":null},"lyBarModerators":{"list":[{"id":"d488fa875df011e9972100163e0462f1","isDel":0,"createAt":1555162398021,"createBy":"84404015eff611e6a61c00163e04584d","createName":"13911686944","updateAt":0,"updateBy":null,"updateName":null,"applyId":"b28735085df011e9972100163e0462f1","userId":"84404015eff611e6a61c00163e04584d","webType":0,"barId":"1935","status":0,"forumUser":{"id":"84404015eff611e6a61c00163e04584d","isDel":0,"createAt":1486775274108,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"username":"13911686944","password":"000000","level":0,"nickName":"赵金亮","realName":null,"signName":"c","head":null,"phone":"13911686944","mobile":null,"wechat":null,"qq":null,"email":null,"address":null,"identityType":6,"userType":2,"isPhoneBind":1,"status":0,"accountSource":0,"isStrangerMsg":0,"departmentId":null,"departmentName":null,"sex":1,"provinceId":"110000","cityId":"","userLevel":0,"modifyNameCount":1}}],"list4Map":null,"pageBegin":0,"pageSize":8,"pageNumber":1,"totalPage":1,"totalRow":1},"metaSearch":{"description":"为您提供:糖尿病的早期症状有哪些_糖尿病的症状有哪些等相关信息，让病友在便捷的求医路上不花一分冤枉钱。","keywords":"糖尿病的早期症状有哪些_糖尿病的症状有哪些","title":"糖尿病的早期症状有哪些_糖尿病的症状有哪些","channels":null},"data":{"list":[{"id":"25402","isDel":0,"createAt":1556460244220,"createBy":"84404015eff611e6a61c00163e04584d","createName":"13911686944","updateAt":0,"updateBy":null,"updateName":null,"userId":"84404015eff611e6a61c00163e04584d","title":"糖尿病血脂异常怎么办","content":"

因为糖代谢与脂代谢之间存在着千丝万缕的联系，糖尿病经常伴有血脂异常，糖尿病血脂异常怎么办

 

发生2型糖尿病的主要机制是胰岛素抵抗，而胰岛素抵抗也是高甘油三酯血症的重要机制，因此糖尿病患者最常见的血脂异常类型是高甘油三酯血症。对于合并高甘油三酯血症的糖尿病患者，要积极控制血糖。血糖控制的理想，甘油三酯也会有所下降。更重要的是要积极控制饮食、增加运动、减轻体重，做到这几点有助于改善胰岛素抵抗，一些轻症患者无需用药就能把血糖和甘油三酯控制好。

 \"糖尿病血脂异常怎么办\"

如果甘油三酯严重升高（≥5.6 mmol/L），很容易发生急性胰腺炎，应立即应用非诺贝特治疗，尽快将其控制在相对安全的范围内。对糖尿病患者身体健康影响最大的并不是甘油三酯，而是胆固醇。因为动脉粥样硬化病变（特别是心肌梗死和脑梗死）是糖尿病患者最常发生的严重并发症，而胆固醇是形成动脉粥样硬化病变的“原材料”，所以对于糖尿病患者而言，严格控制胆固醇水平具有更为重要的意义。一般来讲，糖尿病患者的低密度脂蛋白胆固醇应该控制在2.6 mmol/L以下，如果患者已经发生了冠心病或脑血管病，或者合并高血压等多种危险因素，应该将低密度脂蛋白胆固醇控制在1.8 mmol/L以下。只有这样，才能显著降低发生心血管并发症的风险。为达到这一目标，多数40岁以上的糖尿病患者都需要他汀治疗。

 

所以说，对于合并血脂异常的糖尿病患者而言，应坚持良好的饮食运动习惯、合理控制血糖、积极应用他汀，这是基本的治疗原则。

 \"糖尿病血脂异常怎么办\"

欢迎扫描二维码加入QQ群，听听病友们怎么说，听听医生怎么说



","barId":"1935","topicTypeId":"2","topicThemeId":"1029","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1590,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1556460244225,"isCream":0,"canReply":0,"shareUrl":null,"foodCouponVal":1,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":1,"digestEffectTime":1564322665119,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":1556460244225,"metaSearch":null,"rn":0,"barTitle":null,"checkcode":null,"forumUser":{"id":"84404015eff611e6a61c00163e04584d","isDel":0,"createAt":1486775274108,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"username":"13911686944","password":"000000","level":0,"nickName":"赵金亮","realName":null,"signName":"c","head":null,"phone":"13911686944","mobile":null,"wechat":null,"qq":null,"email":null,"address":null,"identityType":6,"userType":2,"isPhoneBind":1,"status":0,"accountSource":0,"isStrangerMsg":0,"departmentId":null,"departmentName":null,"sex":1,"provinceId":"110000","cityId":"","userLevel":0,"modifyNameCount":1},"lyTopicReply":null,"createAtStr":null,"lyBar":null,"lyTopic":null},{"id":"27482","isDel":0,"createAt":1571735014954,"createBy":"425fdc1d2e6111e8a3d800163e04584d","createName":"求一红颜笑看余生","updateAt":0,"updateBy":null,"updateName":null,"userId":"425fdc1d2e6111e8a3d800163e04584d","title":"糖尿病对关节有影响吗","content":"

在找良医网的糖尿病群内，有病人问过这样的问题，糖尿病对关节有影响吗？找良医网告诉你，糖尿病对关节是有影响的我们一起往下看！

\"糖尿病对关节有影响吗\" 

1、血糖控制不佳可能导致关节疼痛加重；

2、长期血糖控制不佳可能导致长期反复的关节肿；

3、对于肩关节，糖尿病可能导致神经营养或支配的障碍；

4、糖尿病患者需要控制血糖，而血糖的高低与饮食有密切关系，因此糖尿病患者饮食控制的好坏，直接影响到病情的发展。

 

适合糖尿病人吃的4种食物

 

1、怀山药：抑制餐后血糖

 

山药含有黏液成分，这种粘性的蛋白质可以包裹住肠道里的食物，让食物缓慢吸收。既能抑制餐后血糖的迅速上涨，又能避免胰岛素分泌的失调，使血糖得到更好的调节。

 

山药中的镁、锌、维生素B1和维生素B2。这些成分能促进血液中的葡萄糖代谢。另外山药还含有淀粉酶，它是一种分解糖的酶，能阻止血液中糖分的积累。吃山药最好生吃，能更有助于摄取粘稠的成分，优质的山药越粘稠，降糖效果越好。

 

2、洋葱：降低血糖

 

洋葱可有效预防“富贵病”，洋葱含有黄尿丁酸，可使细胞更好利用糖分，从而降低血糖。洋葱还含有前列腺素，可扩张血管，减少外周血管阻力，促进钠的排泄，使增高的血压下降。

生食洋葱前最好切开放置15分钟，让洋葱中的有效物质充分氧化才能发挥作用。

 

3、桑叶：降血糖、预防糖尿病

 

桑叶不但能养蚕，长期以来还被用作治疗糖尿病的传统中药。桑叶内含有一种叫做1-脱氧野尻霉素（DNJ）的生物碱，这是一种仅存在于桑叶中的一种生物碱，含量约100mg/100g，这种生物碱是一种α-糖苷酶的抑制剂。

桑叶茶适宜餐前饮用，能显著抑制餐后血糖。

 

4、膏方：补益肝肾，养血活血，舒筋活络

 

可以选择无糖型膏方食用，但是要在医生的建议指导下正确服用。用于肝肾不足、血瘀气滞、脉络痹阻所致的骨性关节炎、腰肌劳损，症见关节肿胀、疼痛、麻木、活动受限。

建议每次10克,（约1勺）每日2-3次。早晚服用，或遵医嘱服用。    

\"糖尿病对关节有影响吗\" 

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","barId":"1935","topicTypeId":"2","topicThemeId":"1029","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1774,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1571735014955,"isCream":0,"canReply":0,"shareUrl":null,"foodCouponVal":1,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":1571735014955,"metaSearch":null,"rn":0,"barTitle":null,"checkcode":null,"forumUser":{"id":"425fdc1d2e6111e8a3d800163e04584d","isDel":0,"createAt":1521785589502,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"username":"求一红颜笑看余生","password":"zx13401068656","level":0,"nickName":"找良医网问答助手","realName":null,"signName":"找良医网问题解答专员！","head":"http://01luntan.com/ly_img/1539831954338.png","phone":null,"mobile":null,"wechat":null,"qq":null,"email":"1769604826@qq.com","address":null,"identityType":5,"userType":2,"isPhoneBind":0,"status":0,"accountSource":0,"isStrangerMsg":0,"departmentId":null,"departmentName":null,"sex":1,"provinceId":"110000","cityId":"110114","userLevel":0,"modifyNameCount":1},"lyTopicReply":null,"createAtStr":null,"lyBar":null,"lyTopic":null},{"id":"26856","isDel":0,"createAt":1568620974695,"createBy":"425fdc1d2e6111e8a3d800163e04584d","createName":"求一红颜笑看余生","updateAt":0,"updateBy":null,"updateName":null,"userId":"425fdc1d2e6111e8a3d800163e04584d","title":"什么是糖尿病前期状态","content":"

对于糖尿病来说，如果控制不好，极容易造成心梗的发生，糖尿病也是心梗的重要因素之一，在丁荣晶教授《心肌梗死与心肌康复》读者交流群里，就有病人问过，什么是糖尿病前期状态？找良医网在本文中为您解答这个问题。

\"什么是糖尿病前期状态\" 

顾名思义，糖尿病前期就是血糖已经高于正常，但尚未达到糖尿病的诊断标准。

 

空腹血糖<6.1 mmol/L且口服葡萄糖耐量试验（喝糖水前、后测量血糖的试验）的2小时血糖<7.8 mmol/L为正常血糖水平。

 

糖尿病前期包括空腹血糖受损和糖耐量异常两种情况。空腹血糖受损是指口服葡萄糖耐量试验的2小时血糖<7.8 mmol/L，且空腹血糖处于6.1~7.0 mmol/L之间；糖耐量异常是指空腹血糖<7.0 mmol/L，且口服葡萄糖耐量试验的2小时血糖在7.8~11.1 mmol/L之间。

 

糖尿病前期患者进展为糖尿病的风险很高，且患心脑血管疾病风险也增高，需要积极治疗。      

 \"什么是糖尿病前期状态\"

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","barId":"1935","topicTypeId":"2","topicThemeId":"1029","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1601,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1568620974696,"isCream":0,"canReply":0,"shareUrl":null,"foodCouponVal":1,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":1568620974696,"metaSearch":null,"rn":0,"barTitle":null,"checkcode":null,"forumUser":{"id":"425fdc1d2e6111e8a3d800163e04584d","isDel":0,"createAt":1521785589502,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"username":"求一红颜笑看余生","password":"zx13401068656","level":0,"nickName":"找良医网问答助手","realName":null,"signName":"找良医网问题解答专员！","head":"http://01luntan.com/ly_img/1539831954338.png","phone":null,"mobile":null,"wechat":null,"qq":null,"email":"1769604826@qq.com","address":null,"identityType":5,"userType":2,"isPhoneBind":0,"status":0,"accountSource":0,"isStrangerMsg":0,"departmentId":null,"departmentName":null,"sex":1,"provinceId":"110000","cityId":"110114","userLevel":0,"modifyNameCount":1},"lyTopicReply":null,"createAtStr":null,"lyBar":null,"lyTopic":null},{"id":"26219","isDel":0,"createAt":1565774106359,"createBy":"425fdc1d2e6111e8a3d800163e04584d","createName":"求一红颜笑看余生","updateAt":0,"updateBy":null,"updateName":null,"userId":"425fdc1d2e6111e8a3d800163e04584d","title":"糖尿病最严重的后果是什么样的","content":"

我们都知道糖尿病危害很大，那么就有人问了，糖尿病最严重的后果是什么样的？找良医网告诉你，最严重的后果是猝死。糖尿病人患心血管病的危险远高于非糖尿病人，因此，发生心梗或者猝死的可能性也较高。

\"糖尿病最严重的后果是什么样的\" 

糖尿病人也易得脑梗死，除可能致死外，还可能产生半身不遂、失语等严重后果。

 

得了糖尿病的其他并发症包括肾衰、下肢动脉疾病和眼底病变等也会痛苦。肾衰的人需要透析，否则就没尿。严重缺血的下肢动脉疾病都是半夜疼，一晚上都睡不着觉。严重的眼底病变会影响视力，甚至失明。

 

其实，什么病都很痛苦，要不怎么叫病呢？

 

糖尿病是可以预防的，得了糖尿病也可以预防并发症的发生。多数人发展成严重的并发症可能有几个原因：

 

1、保健水平或自我意识差，没有早期发现糖尿病，因为这个病早期没有症状。

 

2、知道有糖尿病，满不在乎，因为无症状，放任自流。

 

3、也想好好控制，但没有毅力，不能坚持。因为拿药麻烦，坚持健康的生活方式都需要自己的努力。

 

总体而言，每个人的健康掌握在自己手中。凡是有因果，求人不如求己。        

 \"糖尿病最严重的后果是什么样的\"

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","barId":"1935","topicTypeId":"2","topicThemeId":"1029","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1403,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1565774106360,"isCream":0,"canReply":0,"shareUrl":null,"foodCouponVal":1,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":1565774106360,"metaSearch":null,"rn":0,"barTitle":null,"checkcode":null,"forumUser":{"id":"425fdc1d2e6111e8a3d800163e04584d","isDel":0,"createAt":1521785589502,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"username":"求一红颜笑看余生","password":"zx13401068656","level":0,"nickName":"找良医网问答助手","realName":null,"signName":"找良医网问题解答专员！","head":"http://01luntan.com/ly_img/1539831954338.png","phone":null,"mobile":null,"wechat":null,"qq":null,"email":"1769604826@qq.com","address":null,"identityType":5,"userType":2,"isPhoneBind":0,"status":0,"accountSource":0,"isStrangerMsg":0,"departmentId":null,"departmentName":null,"sex":1,"provinceId":"110000","cityId":"110114","userLevel":0,"modifyNameCount":1},"lyTopicReply":null,"createAtStr":null,"lyBar":null,"lyTopic":null},{"id":"26209","isDel":0,"createAt":1565687729211,"createBy":"425fdc1d2e6111e8a3d800163e04584d","createName":"求一红颜笑看余生","updateAt":0,"updateBy":null,"updateName":null,"userId":"425fdc1d2e6111e8a3d800163e04584d","title":"发生低血糖怎么办","content":"

正常人有时候在不注意的情况下，都会发生低血糖的情况，所以，糖尿病人更要注意预防，那么，发生低血糖怎么办？找良医网告诉你，糖尿病人比较常发生低血糖，低血糖可导致不适甚至危及生命。

 \"发生低血糖怎么办\"

低血糖可以表现为心慌、焦虑、出汗、饥饿、注意力不集中、反应迟钝、暴躁、易怒甚至抽搐、昏迷等多种表现，老年人还常会发生行为异常，经常发生低血糖的人可能没有任何症状就直接昏迷。

 

低血糖治疗的原则就是快速补糖。

 

发生低血糖要马上补充任何含糖高的食物，如糖果、饼干、果汁等，如果出现了意识不清、昏迷，需要静脉注射葡萄糖等治疗，要立即就医。        

 \"发生低血糖怎么办\"

欢迎扫描二维码加入QQ群，听听病友们怎么说，听听医生怎么说！


","barId":"1935","topicTypeId":"2","topicThemeId":"1029","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1554,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1565687729212,"isCream":0,"canReply":0,"shareUrl":null,"foodCouponVal":1,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":1565687729212,"metaSearch":null,"rn":0,"barTitle":null,"checkcode":null,"forumUser":{"id":"425fdc1d2e6111e8a3d800163e04584d","isDel":0,"createAt":1521785589502,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"username":"求一红颜笑看余生","password":"zx13401068656","level":0,"nickName":"找良医网问答助手","realName":null,"signName":"找良医网问题解答专员！","head":"http://01luntan.com/ly_img/1539831954338.png","phone":null,"mobile":null,"wechat":null,"qq":null,"email":"1769604826@qq.com","address":null,"identityType":5,"userType":2,"isPhoneBind":0,"status":0,"accountSource":0,"isStrangerMsg":0,"departmentId":null,"departmentName":null,"sex":1,"provinceId":"110000","cityId":"110114","userLevel":0,"modifyNameCount":1},"lyTopicReply":null,"createAtStr":null,"lyBar":null,"lyTopic":null},{"id":"26202","isDel":0,"createAt":1565602121622,"createBy":"425fdc1d2e6111e8a3d800163e04584d","createName":"求一红颜笑看余生","updateAt":0,"updateBy":null,"updateName":null,"userId":"425fdc1d2e6111e8a3d800163e04584d","title":"糖前有三多一少症状吗","content":"

很多糖尿病人都不知道什么是三多一少，那么，糖前有三多一少症状吗？没有三多一少的症状，就不会有糖尿病吧？找良医网告诉你，我们常说“三多一少”（多饮、多食、多尿、消瘦）是糖尿病的症状，但很多患者并没有这些典型症状。

\"糖前有三多一少症状吗\" 

多数人可能只表现为疲劳、乏力、皮肤瘙痒等不典型的症状，甚至没有什么症状。

 

所以，有典型症状的只是少数，不能根据有没有症状来判断自己是否得了糖尿病。

 

有些糖尿病患者由于没有明显症状，多年不知已患糖尿病，甚至在出现了并发症的相关症状时才被诊断，比如视力下降（糖尿病眼底病变）；皮肤刺痛、发麻（糖尿病神经病变）；尿蛋白增多（糖尿病肾病）、胸痛（冠心病）等。

 

所以，定期查血糖才是早期发现糖尿病、早期治疗、预防并发症的靠谱方法。        

 \"糖前有三多一少症状吗\"

欢迎扫描二维码加入QQ群，听听病友们怎么说，听听医生怎么说！


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\"56cd1ad144c45.jpg\"/

前几天刘先生来看眼科，他说：“近几个月来眼睛看电脑有时清清楚楚，有时又模模糊糊。”

我问他：“你多大年纪了，是干什么的？”

他说：“今年35岁，业务推销。”

“喝酒吗？你体重近来有变化吗”

“就是经常喝酒，生活一点也不规律，近几个月好像还瘦了十多斤，而且容易疲劳。”

我给他检查发现好像后囊下皮质区有无数分散的灰色点状混浊。

我问他“你有糖尿病吗？”

“不知道，我父亲好像有糖尿病十年了，他经常服治疗糖尿病的药。”

“这样吧，你明天不吃早餐抽血验血糖。”

今天我刚上班他就把化验报告给我。“啊，血糖还不低啦，空腹血糖14.2mmol/L，糖化血红蛋白8.2%，你有糖尿病”。我告诉他。

“啊！我也有糖尿病，是糖尿病引起眼睛看东西模糊吗？”他有点惊讶。

我说：“是的，当血糖升高时，房水渗入晶状体内，使之更加变凸，形成近视。当血糖降低时，晶状体内水分渗出，晶状体变扁平，形成远视，所以你电脑有时清楚，有时模糊。近几个月你没有做体育锻炼，没有吃减肥药，体重减轻了十多斤，这也是糖尿病初期症状。因为在糖尿病初期症状时，血液内的葡萄糖不能被充分利用，从而使得糖尿病初期患者的体重突然减轻。”

我这么一说他的情绪一下就低落了，看上去他有些紧张。

我告诉他：“你也不要太着急，糖尿病是全球性疾病，目前全球糖尿病患者估计全球有1.2亿，有人预计到2025年全球糖尿病患者达3.8亿，我国是全球糖尿病患者人数最好多的国家之一，也是糖尿病患者增长最快的国家之一，目前我国至少有糖尿病患者2000万，尤其是北京、上海、广州等大城巿，糖尿病患病率高达8%左右。你只有控制好血糖，预防糖尿病的并发症也问题不大。”

“那我现在怎么办咧。”

“你去看内分泌科，控制好血糖，一般3个月来看看眼科，如眼睛有变化随时来找我。”我顺手递给他一张名片，告诉他我上班的时间。

“谢谢张教授。”他走出了诊室。

我看着他离去的背影，心想他要早点自己注意生活习惯，不饮酒或少饮酒，避免进甜食、高脂食品，多做运动，生活有规律性，也许他不会发病；如果发现体重变化快，视力变化快，也应该早点就医；如果他从现在起注意饮食、适当运动、药物治疗、加强血糖监测，也许可以防止或延缓并发症的发生和发展。


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\"56cd1ad144c45.jpg\"

\n

在临床工作时，常常会遇到有糖尿病患者告诉我有一过性视物模糊现象，检查眼睛，发现晶状体透明，没有白内障，眼底未见微动脉瘤及出血，黄斑区也未见明显异常。

\n

是什么原因导致一过性视物模糊现象呢？

\n

分析可能与血糖波动有关，血糖升高，眼部晶状体的渗透压随之增加，晶状体吸收周围组织的水分，导致屈光度增加，出现一过性视物模糊，随着血糖降低，眼部晶状体的渗透压随之降低，晶状体逐渐恢复正常屈光度，使视物模糊现象得以缓解。

\n

当然也不排除血管一过性的痉挛导致的视网膜供血不足。

\n

所以，如果糖尿病患者出现一过性视物模糊现象，应积极到正规医院眼科检查，排除是否有眼底视网膜供血不足或出血，同时密切检测血糖（空腹及三餐后2小时血糖）及糖化血红蛋白，并在内分泌科医生指导下积极控制血糖，延缓白内障的形成及糖尿病视网膜病变的发生。

\n

 

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1、糖尿病视网膜病变有哪些主要表现及危害？

糖尿病视网膜病变是糖尿病的严重并发症，已经成为主要致盲眼病之一。其发生与糖尿病的病程和血糖控制情况密切相关，随病程的延长发生率逐渐增高，良好地血糖控制可以延缓但不能完全避免其发生。

长期高血糖导致视网膜的微血管产生损害，早期血管的渗透性增加，血管内的液体或其它成分渗入视网膜，出现微动脉瘤、出血点、硬性或软性渗出，视网膜静脉扩张，视力轻度到中度下降，临床上称为单纯型；由于视网膜的长期缺血缺氧，经过一段时间后，视网膜上会长出一些小的新生血管，称为增殖型，这些异常的血管非常容易破裂出血，出血多了就严重影响视力，反复的出血还可以导致玻璃体视网膜机化膜的形成，引起继发性视网膜脱离，甚至并发新生血管性青光眼，导致失明及眼球萎缩。

2、如何早期发现糖尿病视网膜病变？

早期发现是及时主动治疗的关键。所有的糖尿病患者都应根据糖尿病病程及眼科医生检查的情况，每3-12个月行眼底检查，病情严重者应缩短检查间期。如果检查发现有视网膜异常，通常会要求进行眼底荧光血管造影检查，该检查对了解糖尿病视网膜病变的程度、选择治疗方案、指导光凝治疗、客观判断疗效均有极其重要的价值，有些患者半年到1年左右需要复查1次造影。根据情况还可以进行视觉电生理、视野、OCT等检查。

3、糖尿病视网膜病变如何治疗？

根本性治疗是严格地内科治疗，包括饮食治疗、口服降糖药、使用胰岛素及中医中药治疗，同时可以辅助性使用活血化淤的药物和维生素等，早期严格血糖控制可以显著延缓其发生。

通过眼底血管造影检查，确定视网膜病变严重即将或已经发生新生血管，及时进行视网膜光凝治疗非常重要。在目前尚无彻底根治和预防糖尿病视网膜病变的情况下，光凝治疗被证实是防止糖尿病视网膜病变失明唯一有效的方法，成为目前治疗及预防糖尿病视网膜病变失明的主要手段。对于严重的玻璃体积血及视网膜有增殖、牵拉、脱离的患者，只有进行玻璃体切割手术治疗才能恢复部分视力，术前玻璃体腔内注射抗VEGF药物能使手术中出血减少，术后视力恢复更好些，缺点是价格昂贵。

4、糖尿病视网膜病变光凝治疗的机理是什么？

光凝治疗的可能机理是：消除新生血管，减轻视网膜水肿，使异常的渗漏出血的血管闭塞；破坏部分代谢旺盛、耗氧量大的细胞，改善视网膜的缺氧状态，有利于保证重要部位黄斑的血氧供应；光凝形成的瘢痕可以抵抗对视网膜的牵拉，防止视网膜脱离。

5、糖尿病视网膜病变光凝的方法有哪些？

根据眼底检查及造影结果确定的疾病的严重程度，可以采用标准全视网膜光凝术、黄斑区格栅样光凝、局部光凝等方法，通常分3-5次完成，每次间隔1-2周进行。有些患者在完成激光治疗经过一段时间后，经检查如有必要还需要补充光凝治疗。

6、实施光凝治疗前有哪些注意事项？

首先要有近期的眼底荧光血管造影结果，帮助医生明确视网膜新生血管的部位及严重程度，以便指导准确治疗。有屈光间质不清，比如有角膜浑浊、白内障、玻璃体眼底出血较多时，阻碍光线通过，均不利于光凝治疗，有些患者需要先摘除白内障。

增殖性糖尿病视网膜病变如不及时治疗，往往在较短的时期内就会因出血及视网膜脱离而失明，光凝并非能完全阻止其发展，只是能大大减少出血的机会和程度，降低严重视力丧失的比例，所有接受光凝的患者对此应有明确的认识，甚至有少数严重患者在等待激光治疗的过程中发生大出血而被迫手术治疗。

7、光凝治疗中应注意哪些事项？

患者经检查确定要进行视网膜光凝治疗时，凭激光治疗收费单到门诊三楼眼科手术室登记预约，按照指定的时间，携带造影结果及病历，到激光室外等候工作人员滴药。

在治疗过程要保持心态平静，不要紧张，尽量保持头位不动，以免影响激光的准确瞄准治疗，另一只眼闭上，避免激光散射引起损伤。治疗中可能有轻微的酸胀痛感，不能忍受或有其它特殊情况及时向医生说明，医生会适当调整，千万不要突然大幅度移动头位，防止激光造成其它地方的损伤。

8、光凝治疗术后可能出现哪些并发症？

糖尿病视网膜病变晚期，无论采用什么方法治疗，都难以恢复理想的视功能，虽然光凝治疗对视功能有一定负面影响，但是对挽救和维持患者的有用视力是非常有效的，而且这种治疗的风险是很低的，光凝治疗后能降低大约超过60%已进展的糖尿病视网膜病变严重失明的危险，但是不能避免所有的出血及视力下降。

视网膜光凝的并发症发生率较低，极少数患者可能出现早期视力暂时性下降（半年左右才能恢复并保持稳定）、角膜上皮糜烂、晶体浑浊加重、眼压一过性升高、葡萄膜炎、黄斑水肿的加重、渗出性视网膜脱离、视网膜的新生血管破裂出血、视野改变等，这些情况的发生与患者疾病本身还在发展的状况、治疗过程中配合的程度、激光本身的副作用等因素有关，一般不会引起严重后果。

9、光凝治疗后为什么还要复查，如何复查随访？

糖尿病视网膜病变光凝治疗的成功需要与血糖的控制、其它辅助的药物治疗相结合，而且要在不断的观察中确认和调整，因此，病人的积极主动随诊非常重要。一般全视网膜光凝后2-3月应重新评估新生血管的活动情况，如果新生血管已萎缩，而且光凝色素斑分布均匀，患者可3个月以后再复诊，全视网膜光凝治疗后2-3月做眼底血管荧光造影发现如果仍有新生血管生长，需要补充光凝治疗。长期的研究表明，那些视力较好的患者与他们积极的随访密切相关。

总之，糖尿病视网膜病变的病情复杂多样，晚期视力预后较差，激光治疗是糖尿病视网膜病变的主要治疗手段，积极主动进行激光治疗是挽救患者视功能和提高其生活质量的关键所在。

切记：早期的激光预防性治疗比后期任何复杂手术治疗都更简单、经济、有效。


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大家好，今天在协和糖尿病大讲堂我又和大家见面了。有很多熟悉的面孔令我倍感亲切。我在糖尿病领域工作了20年，有些面孔也看了十几年了。每次见到大家都很阳光、健康，我也非常快乐。

很多糖尿病人很关注自己的症状，想了解这些症状是怎么回事，如何引起的，又意味着什么，如何解决等。今天我跟大家一起共同探讨这方面的问题。

老年人控糖标准可放宽

经常会有患者跟我讲，“我没劲”或“我血糖挺好的，但就是没劲”。这是什么原因呢？

首先，血糖特别高的时候，肯定会出现没劲的感觉。

其次，血糖持续偏低的时候，也会出现疲乏无力。然而，有些人血糖监测并不低，但仍然会出现没劲。这可能是因为身体并不适应这个血糖值，这时可能要考虑适当地放宽血糖标准。

比如餐前（不仅仅指早晨的餐前，还包括中餐、晚餐和睡前等）的血糖标准是5-7，餐后两小时的血糖值，有人认为应低于8，也有人认为应低于10。事实上，有时候12以内也是可以的。为什么？

因为患者的年龄越大，维持舒适的血糖浓度就越高。随着年龄的增长，血管可能会越来越不通畅，血液中营养物质透过血管，达到组织中供应能量的能力也会降低，因此血糖从血管渗透到组织里的量也会降低。如果身体得不到糖，当然也就没劲了。

然而，这并不是说岁数越大就不需要控制血糖了，而是需要将血糖维持在偏高一点的水平以适合身体的状态。

因此，针对年龄越大的人，血糖的标准就越应该适当放宽。对于70岁以上的人，餐后血糖可以放宽到10-12，个别情况时还可以偶尔再高一点，只要下顿饭前降下来就可以了。

不饿并不代表吃够了

另外，进食量过少也会引起疲乏无力。有人说，“我并不饿，为什么会说进食量少”。然而，饿不饿并不是能量够不够的唯一标准。很多病人都在服用二甲双胍，而二甲双胍有时会让病人感觉不到饿。

因此，不饿不一定就等于吃够了，大家要非常认真地考虑自己到底要吃多少合适。如果总感觉没劲的话，可以尝试稍微多吃一点，然后观察血糖的变化。如果血糖升高不是很多，仅仅升高0.5或1，而疲乏无力的感觉却好了很多，就可以尝试多吃一点。另外空腹的时间过长，如超过4-5小时后乏力、精神不好也应该考虑是否已缺乏能量，需要加餐。

血压偏低也可能导致疲乏无力

此外，血压偏低，也可能会引起疲乏无力。现在医学认为，存在脑血管问题的人，血压不适合降得太低，比如有些人颈部和脑部血管不太通畅。这时，如果血压偏低了，就会影响到这些部位的血供。因此，年纪较大，尤其是对于70多岁的老年人，血压可以适当放宽。

头晕、耳鸣、眼睛酸涩，头部供血很重要

最近，天气转冷，很多人出现头晕、耳鸣的情况。之后，天气越来越冷，室内外温差达到十几二十几度的时候，这个问题可能会更严重。为什么会发生头晕、耳鸣？

头部供血问题是其中的一个重要原因。头部的器官谁最敏感？谁对缺血最敏感？眼睛。如果在一个窗户关闭的房间里坐上一个小时，很多人会眼睛酸涩，甚至犯困，原因就是头部供血和供氧的缺乏。所以，眼睛是心灵的窗户，也是健康的指南针。颈动脉狭窄、血液粘稠度高、血液带氧量低等都可能会引起头晕、耳鸣、眼睛酸涩。

腿沉、腿胀，还要看是否浮肿

好长一段时间不来看病的患者，我会看一下他的下肢远端是否肿胀，主要观察两个地方，一是脚踝，一是小腿下段。用手按一下这两个地方看有没有凹陷，如果有凹下去的感觉，可能就存在可凹性浮肿，如果手感张力较大又按不动，仍然不能完全除外浮肿的可能。

有人做过统计，可凹形浮肿经利尿之后，体重能减少7公斤。当然，水不是仅仅淤积在腿上，而是全身各个组织都有淤积。

那么，引起可凹性浮肿的原因是什么？有人可能会马上想到肾脏，但其实肝脏、心脏、甲状腺存在问题的话，也都可能会引起浮肿。因此，出现这种情况，要综合考虑，而不是仅仅考虑肾脏的问题。

而腿沉腿胀并没有浮肿，只是在走路后伴酸胀，这时要警惕下肢动脉狭窄，造成腿部血管缺血。其中，很严重的一种情况是间歇性跛行，就是走一段比如几十米的路后必须要停下来。因为腿部在运动后出现缺血，当停下来后，缺血症状改善后就又可以走路了。

因此，对于没有浮肿的腿沉腿胀的情况，患者可能就要定期查下肢各级动脉超声，发现有无下肢动脉狭窄。


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　  糖尿病早期症状

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　　1、饥饿和多食：因体内的糖份作为尿糖排泄出去，吸收不到足够的热量维持身体的基本需求，会常常感到异常的饥饿，食量大增，但依旧饥饿如故;平时不吃甜食的人也开始不加选择地吃很多甜食，这就需要去医院检查了，这些异常症状往往是糖尿病的先兆。

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　　2、手脚麻痹、发抖：糖尿病人会有顽固性手脚麻痹、手脚发抖、手指活动不灵及阵痛感、剧烈的神经炎性脚痛，下肢麻痹、腰痛，不想走路，夜间小腿抽筋、眼运动神经麻痹，重视和两眼不一样清楚，还有自律神经障碍等症状，一经发现就要去医院检查，不得拖延。此外，糖尿病人应多加预防骨质疏松。

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    糖尿病人会有顽固性手脚麻痹、手脚发抖、手指活动不灵及阵痛感、剧烈的神经炎性脚痛

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　　3、疲劳、血压高、尿液发白：糖尿病会感到容易疲劳，全身倦怠无力。没有从事劳动或体育运动，身体常常无原由地感到疲惫不堪，感到双腿乏力，膝盖酸软，尤其是上下楼梯的时候;感冒后经常长疖疮或血压高，尿液白色，有甜酸气味，此时就该及早去医院检查了。

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　　糖尿病在早期的时候是非常的难受的，如果自己觉得身体不舒服，难受，这就说明糖尿病已经是很严重了，这就要及时的治疗。

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　　4、眼睛疲劳、视力下降：眼睛容易疲劳，视力急剧下降。当感到眼睛很容易疲劳，看不清东西，站起来时眼前发黑，眼皮下垂，视界变窄，看东西模糊不清，眼睛突然从远视变为近视或以前没有的老花眼现象等，要立即进行眼科检查，上述症状就是糖尿病会引起的视力障碍、视网膜出血、白内障、视力调节障碍等疾病的明显表现。

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　　5、体重下降：中年人的身体日渐肥胖，食欲也正常，一旦发现体重下降很快，就应考虑是否的了糖尿病。因肥胖会增大胰岛素的需求量，导至病情急剧恶化。

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　　6、酮症酸中毒的症状：腹痛、恶心、呕吐，呼吸快而深、昏睡、神志不清，甚至昏迷。

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　　7、多尿：尿液多是孩子糖尿病最明显咋症状，可能有一些大一点的孩子还是会出现尿床的现象。

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　　8、皮肤和阴部瘙痒或反复的泌尿系统感染：往往表现为腹痛和呕吐，因进食不足和反复呕吐使血糖水平暂时下降，或因肾糖阈异常，而出现尿糖阴性的表现，容易导致漏诊。　　

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