{"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":"1036","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:怎样预防糖尿病的发生_糖尿病预防和注意事项_遗传糖尿病如何预防等相关信息，让病友在便捷的求医路上不花一分冤枉钱。","keywords":"怎样预防糖尿病的发生_糖尿病预防和注意事项_遗传糖尿病如何预防","title":"怎样预防糖尿病的发生_糖尿病预防和注意事项_遗传糖尿病如何预防","channels":null},"data":{"list":[{"id":"25535","isDel":0,"createAt":1558019151820,"createBy":"84404015eff611e6a61c00163e04584d","createName":"13911686944","updateAt":0,"updateBy":null,"updateName":null,"userId":"84404015eff611e6a61c00163e04584d","title":"糖尿病能吃他汀类药物吗","content":"

动脉粥样硬化性心血管疾病（如冠心病、心肌梗死与脑梗死等）是糖尿病患者致死致残的主要原因，糖尿病患者要积极控制血压并根据患者具体情况应用他汀降低胆固醇水平，糖尿病能吃他汀类药物吗？

 \"糖尿病能吃他汀类药物吗\"

哪些糖尿病患者需要接受他汀治疗？

所有确诊动脉粥样硬化性心血管疾病（冠心病、缺血性卒中、外周动脉疾病[如预动脉或下肢动脉狭窄超过50%]等）的患者，无论其胆固醇是否增高，均应长期应用他汀治疗，并将低密度脂蛋白胆固醇（LDL-C）降低至＜1.8mmol/L；

 

未合并心血管病者，首先要根据其否存在其他心血管危险因素确定LDL-C的目标值，若患者LDL-C水平超过此目标值则应予以他汀治疗。不同糖尿病患者的LDL-C目标值如下：

 

1）合并至少一项其他危险因素（男≥45岁，女≥55，高血压，吸烟，HDL-C＜1.04mmo/L，体质指数≥28Kg/m2，早发缺血性心血管病家族史），LDL-C目标值＜1.8mmo/L；



2）不伴其他危险因素，LDL-C目标值＜2.6mmo/L。

 

特别强调：

糖尿病患者最常见的血脂紊乱是甘油三酯增高或高密度脂蛋白胆固醇降低，但这并不意味着应该应用贝特类或烟酸类药物对此进行干预。如果甘油三酯严重增高（≥5.6 mmol/L）可首选贝特治疗。其他患者均应将他汀作为首选的降脂药，降低胆固醇水平是最重要的治疗目标。

 

很多学者建议，所有40岁以上的糖尿病患者都应该服用他汀，无论胆固醇高还是不高。这种观点也是很有道理的。把糖尿病人的胆固醇降得低一些，心脑血管就会安全一些，就不容易发生心梗、脑梗。

\"糖尿病能吃他汀类药物吗\"

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","barId":"1935","topicTypeId":"3","topicThemeId":"1036","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1652,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1558019151824,"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":1565968338151,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":1558019151824,"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":"25470","isDel":0,"createAt":1557408670188,"createBy":"84404015eff611e6a61c00163e04584d","createName":"13911686944","updateAt":0,"updateBy":null,"updateName":null,"userId":"84404015eff611e6a61c00163e04584d","title":"糖尿病患者需要注意哪些事项","content":"

糖尿病患者最大的威胁就是心脑血管疾病(如冠心病、心肌梗死、脑梗死等)。因此，预防控制好心脑血管疾病是糖尿病患者的首要任务。首先，糖尿病患者应在医生指导下接受正规的降糖治疗。但对于多数患者而言，仅仅关注血糖是不够的，糖尿病患者还需要注意哪些事项呢？

 \"糖尿病患者需要注意哪些事项\"

生活方式管理

主要内容包括合理饮食、适量运动、控制体重、限制饮酒、戒烟等。首先，合理的饮食结构与总热量摄入不仅是降糖治疗的基石，也是降低心血管系统整体风险水平的有效措施，因而适用于所有糖尿病患者。对于超重（体质指数≥24kg/m2）/肥胖（体质指数≥28kg/m2）的患者，应以低碳水化合物、低脂肪饮食为主。其次，适量运动有助于控制体重、改善糖代谢和脂代谢状态并降低血压水平，对心血管系统具有有益影响。建议糖尿病患者坚持规律性的中等强度有氧运动（例如快步行走、太极拳、自行车运动等）。体重在正常范围者每日运动时间不少于30分钟，每周不少于5天。超重/肥胖者需要增加运动量，每日运动时间不少于1小时，每周不少于5天。若无禁忌证，应鼓励患者每周进行2-3次阻抗训练（如俯卧撑、仰卧起坐、下蹲运动、举哑铃等）。第三，吸烟可以增高不良心血管事件的危险性，因此吸烟者应努力戒烟。

 

血压管理

当糖尿病患者血压水平高于130/80 mmHg时，其不良心血管事件发生率将显著增高，因此多数患者的血压应控制在此水平以下。但是对于高龄、一般健康状况较差或已经发生严重心脑血管疾病的患者，过于严格的血压控制可能会对患者产生不利影响，将血压控制在140/90 mmHg以下就可以了。降压药物可以首选普利类或沙坦类，血压不能达标时可以联合应用地平类或利尿剂等。

 

血脂管理

对于已经发生心脑血管疾病的患者，无论其血脂水平如何，均应接受他汀治疗，将低密度脂蛋白胆固醇（LDL-C）控制在1.8mmol/L以下。没有心脑血管疾病但年龄≥40岁的患者，虽然其血脂水平不高也应该服用他汀类药物，将LDL-C控制于2.6 mmol/L以下。换言之，多数2型糖尿病患者需要接受他汀治疗。

 

抗血小板治疗

若无禁忌证，所有合并心脑血管疾病的患者均应服用小剂量阿司匹林（75-150 mg/d）。具有使用阿司匹林适应证但不能耐受治疗者，可应用氯吡格雷替代（75 mg/d）。无心脑血管疾病的50岁以上男性与60岁以上女性患者且伴有至少1项其他危险因素（吸烟，高血压，血脂异常，早发冠心病家族史，蛋白尿）者，若其不存在出血性并发症的高危因素（既往有胃肠道出血史或消化性溃疡病史，或正在服用非甾体类抗炎药物或华法林等增加出血风险的药物），也建议服用小剂量（75-150 mg/d）阿司匹林。

\"糖尿病患者需要注意哪些事项\"

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":"3","topicThemeId":"1036","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1353,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1557408670189,"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":1565359922483,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":1557408670189,"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":"25374","isDel":0,"createAt":1556200748882,"createBy":"84404015eff611e6a61c00163e04584d","createName":"13911686944","updateAt":0,"updateBy":null,"updateName":null,"userId":"84404015eff611e6a61c00163e04584d","title":"没有三高的人血管为何长斑块","content":"

许多人经常有这样的疑惑：为什么没有三高的人血管为何长斑块，对此问题解答如下：

 

发生动脉斑块的原因很多，最常见的有年龄增长（年龄越大越容易发生）、男性性别（男性比女性容易发生）、遗传因素、高血压、高血糖、高血脂、吸烟、肥胖、缺少运动、长期精神紧张等。其中前三种是我们无法改变的，但后7种是可控的。

 \"没有三高的人血管为何长斑块\"

由此可见，即便没有糖尿病、高血压，血脂也正常，还有其他因素也会导致斑块形成。发生动脉斑块的主要原因就是动脉血管内皮受到破坏，血液中的胆固醇进入了血管壁内，通过一系列的反应过程形成斑块。有的人天生就血管壁较易破坏（遗传因素），年龄越大血管壁也会越来越不完整，所以即便没有其他因素，血液中的胆固醇仍然有可能侵入血管内壁里面，最后导致斑块形成。

所以很多人血压血脂血糖正常也可以发生颈动脉斑块，甚至也会发生心梗、脑梗，但是比有“三高”的人风险要低很多。发生斑块后你应该比别人更加重视改变不健康生活习惯，除了监测血压、血糖、血脂外，还要增加运动，不要吸烟、酗酒，不要肥胖，这些对于预防斑块增长都有帮助。

 

另外，遇到这种情况请化验一下血脂，如果低密度脂蛋白胆固醇超过了3.4 mmol/L，请咨询医生是否需要用一点降胆固醇药物。

简单地说，虽然“三高”是导致动脉斑块形成的重要因素，但并不是唯一的因素，所以没有“三高”也有可能发生斑块。

 

\"没有三高的人血管为何长斑块\"

下载二维码，微信识别，观看丁荣晶教授主讲三小时的《心肌梗死与心肌康复》

\"没有三高的人血管为何长斑块\"

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":"3","topicThemeId":"1036","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1411,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1556200748883,"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":1564063219800,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":1556200748883,"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":"27735","isDel":0,"createAt":1572858166007,"createBy":"425fdc1d2e6111e8a3d800163e04584d","createName":"求一红颜笑看余生","updateAt":0,"updateBy":null,"updateName":null,"userId":"425fdc1d2e6111e8a3d800163e04584d","title":"血糖每周测几次","content":"

在找良医网高血糖病友交流群内，有病人曾经问过这样的问题，血糖每周测几次？找良医网告诉你，糖友们都知道，自己在家要监测血糖。血糖监测的结果有助于评估血糖的控制情况，制订合理的降糖方案。

\"血糖每周测几次\" 

血糖监测的频率和时间要根据个人情况决定，主要看糖化血红蛋白是不是达标（<7%），以及正在接受的降糖治疗。

 

口服降糖药物，且糖化血红蛋白达标者，可使用每周测3天，每天测两次的餐时配对方案，如周一测早餐前、后血糖，周二测午餐前、后血糖，周三测晚餐前、后血糖。

 

口服降糖药物，但糖化血红蛋白没有达标，正在调整治疗方案者，监测方案为连续测3天，每天测5~7个时间点，包括餐前、餐后、睡前。

 

注射胰岛素者，包括每天多次注射胰岛素、使用基础胰岛素、每日2次预混胰岛素，根据糖化血红蛋白是否达标，均有不同的监测方案，原则就是遵医嘱。    

\"血糖每周测几次\" 

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":"3","topicThemeId":"1036","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1618,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1572858166008,"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":1572858166008,"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":"26826","isDel":0,"createAt":1568273693404,"createBy":"425fdc1d2e6111e8a3d800163e04584d","createName":"求一红颜笑看余生","updateAt":0,"updateBy":null,"updateName":null,"userId":"425fdc1d2e6111e8a3d800163e04584d","title":"怎么样预防糖尿病","content":"

糖尿病是心梗的诱发因素之一，怎么样预防糖尿病，也是很多人咨询的问题，在丁荣晶教授《心肌梗死与心肌康复》读者交流群里，丁荣晶教授这样说过，总体而言，应注意饮食多样丰富、多些蔬菜水果，不要暴饮暴食、控制好体重、不吸烟、少喝酒、多运动，保持乐观积极的心态，来综合预防糖尿病。

 

可以参照《中国居民膳食指南》的建议进行饮食和运动。

\"怎么样预防糖尿病\" 

糖尿病前期人群是最重要的发生糖尿病的高危人群，应该采取更严格的措施来预防糖尿病。主要措施就是长期饮食控制和运动，具体目标为：

 

（1）使超重或肥胖者体重指数（体重/身高2）达到或接近24 kg/m2，或体重至少下降7%；

（2）每日饮食总热量至少减少400~500 kcal；

（3）饱和脂肪酸摄入占总脂肪酸摄入的30%以下；

（4）中等强度体力活动至少保持在150分钟/周。

 

这里，我们推荐一些简单易行的方法。

 

第1招：每周至少中等强度运动150分钟。相比不运动的人，每天运动35分钟或每周进行4小时运动的人，其患糖尿病的风险下降80%。

 

第2招：少吃这些东西：快餐、深加工食品、甜饮料、油炸食品。常吃这些食品的人，发生肥胖的危险高，肥胖是糖尿病的主要诱因之一。

 

第3招：用粗粮当主食。粗粮中含有的丰富的膳食纤维，能降低餐后血糖升高的幅度。而细粮增加糖尿病风险。

 

第4招：睡够觉。糖尿病可能会引起睡眠障碍，长期睡眠障碍也会引发糖尿病。

 

第5招：戒烟。吸烟增加糖尿病风险。      

\"怎么样预防糖尿病\" 

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":"3","topicThemeId":"1036","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1713,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1568273693405,"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":1568273693405,"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":"26734","isDel":0,"createAt":1568014227745,"createBy":"425fdc1d2e6111e8a3d800163e04584d","createName":"求一红颜笑看余生","updateAt":0,"updateBy":null,"updateName":null,"userId":"425fdc1d2e6111e8a3d800163e04584d","title":"糖尿病人的运动量越大越好","content":"

在丁荣晶教授《心肌梗死与心肌康复》读者交流群里，丁荣晶教授讲过：对糖尿病人而言，运动是治疗的重要组成部分。运动可以增加葡萄糖的消耗、降低血糖，可以减少或控制其他心血管危险因素，如减轻体重、改善血脂等。那么，糖尿病人的运动量越大越好吗？我们一起往下看！

\"糖尿病人的运动量越大越好\" 

成年2型糖尿病患者每周至少进行150分钟（如每周运动5天，每次30分钟）中等强度的有氧运动，如快走、打太极拳、骑车、乒乓球、羽毛球、广场舞等。如果不能连续运动30分钟，也可以进行短时的体育运动（如10分钟），一天累计30分钟，也是有益的。除规律运动外，糖尿病人要培养活跃的生活方式，如增加日常身体活动，减少静坐时间，将有益的活动融入到日常生活中。

 

需要注意的是，偶尔运动量大或激烈运动时可能需要加强血糖监测，临时调整饮食及药物治疗方案，以免发生低血糖。另外，有心血管疾病者要根据自身情况，在医生指导下运动。      

\"糖尿病人的运动量越大越好\" 

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":"3","topicThemeId":"1036","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1557,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1568014227746,"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":1568014227746,"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":"26731","isDel":0,"createAt":1568013330033,"createBy":"425fdc1d2e6111e8a3d800163e04584d","createName":"求一红颜笑看余生","updateAt":0,"updateBy":null,"updateName":null,"userId":"425fdc1d2e6111e8a3d800163e04584d","title":"糖尿病如何避免低血糖","content":"

在丁荣晶教授《心肌梗死与心肌康复》读者交流群里，对心梗的危险因素之一的糖尿病也有一定的讲解，糖尿病如何避免低血糖？找良医网告诉你，低血糖给糖尿病人带来的危害不逊于高血糖，要重视起来，以下措施可避免低血糖发生：

\"糖尿病如何避免低血糖\" 

1、胰岛素或是口服降糖药都应从小剂量开始使用，逐渐增加剂量，谨慎地调整剂量。

 

2、一日三餐定时定量，不能过度节食，有可能误餐时应提前做好准备，也可以临时调整药物剂量。

 

3、运动量增加时，运动前应增加额外的碳水化合物摄入。

 

4、酒精能直接导致低血糖，应避免酗酒和空腹饮酒。

 

5、严重低血糖或反复发生低血糖者，应在医生指导下调整糖尿病的治疗方案，并适当调整血糖控制目标。

 

6、糖尿病患者应常规随身备用碳水化合物类食品，一旦发生低血糖，立即食用。      

\"糖尿病如何避免低血糖\" 

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":"3","topicThemeId":"1036","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1555,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1568013330034,"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":1568013330034,"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":"26355","isDel":0,"createAt":1566378742420,"createBy":"425fdc1d2e6111e8a3d800163e04584d","createName":"求一红颜笑看余生","updateAt":0,"updateBy":null,"updateName":null,"userId":"425fdc1d2e6111e8a3d800163e04584d","title":"糖尿病人的血糖控制标准","content":"

很多糖尿病人对控制血糖不懂，也有很多2型糖尿病人会问，糖尿病人的血糖控制标准是怎么样的？2型糖尿病人的血糖必须降到标准以内吗？找良医网告诉你，是的，2型糖尿病人的血糖应该尽可能控制在“自己”的标准以内。

\"糖尿病人的血糖控制标准\" 

2型糖尿病的各种并发症，如心脑血管疾病、糖尿病神经病变、视网膜病变、糖尿病足都与血糖控制情况密切相关，血糖控制得好，并发症发生风险就低。

 

我国最新的《2型糖尿病防治指南》建议，2型糖尿病患者的一般血糖控制目标为：糖化血红蛋白<7%、空腹血糖4.4~7.0 mmol/L、非空腹血糖<10 mmol/L。

 

但并不是所有的糖尿病人都是一个目标，血糖的控制也讲究个体化。

 

比如，糖尿病病程短、年纪轻、预期寿命长、还没有出现糖尿病并发症的患者，可以更严格的控制血糖。此时，可以将糖化血红蛋白目标设定在<6.5%，甚或尽可能接近正常。

 

而对于有严重低血糖病史、糖尿病病程很长、预期寿命较短、有明显的糖尿病并发症，或有严重合并症的患者，可以使用相对宽松的糖化血红蛋白目标，如<8.0%。

 

医生会根据您的具体情况确定您的血糖控制目标。

\"糖尿病人的血糖控制标准\" 

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":"3","topicThemeId":"1036","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1609,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1566378742421,"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":1566378742421,"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":"26015","isDel":0,"createAt":1563354584824,"createBy":"425fdc1d2e6111e8a3d800163e04584d","createName":"求一红颜笑看余生","updateAt":0,"updateBy":null,"updateName":null,"userId":"425fdc1d2e6111e8a3d800163e04584d","title":"糖尿病可以泡脚吗","content":"

很多病人问过医生，糖尿病可以泡脚吗？如果是放了支架了，可以泡脚吗？找良医网告诉你，这当然可以。但别太烫，容易烫伤。尤其是老糖尿病人，末梢神经一般不太好，对温度的感觉比较迟钝。

\"糖尿病可以泡脚吗\" 

糖尿病人需注意保护足部：

 

1. 每天检查双足，特别是足趾间；

 

2. 定期洗脚，用干布擦干，尤其是擦干足趾间；

 

3. 洗脚时的水温要合适，低于37℃；

 

4. 不宜用热水袋、电热器等物品直接保暖足部；

 

5. 避免赤足行走；

 

6. 穿鞋前先检查鞋内有否异物或异常；

 

7. 不穿过紧的或毛边的袜子或鞋；

 

8. 足部皮肤干燥可以使用油膏类护肤品；

 

9. 每天换袜子、不穿高过膝盖的袜子；

 

10. 水平地剪趾甲；

 

11. 避免自己修剪胼胝（俗称老茧）或用化学制剂来处理胼胝或趾甲，应由专业人员修剪；

 

12. 一旦足部出现问题，及时找到专科医师诊治。                

 \"糖尿病可以泡脚吗\"

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！


","barId":"1935","topicTypeId":"3","topicThemeId":"1036","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1591,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1563354584825,"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":1563354584825,"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":"26011","isDel":0,"createAt":1563268181239,"createBy":"425fdc1d2e6111e8a3d800163e04584d","createName":"求一红颜笑看余生","updateAt":0,"updateBy":null,"updateName":null,"userId":"425fdc1d2e6111e8a3d800163e04584d","title":"糖尿病高危人群的定义","content":"

很多人觉得糖尿病离自己很远，不可能有这种疾病发生，那么，你真的知道糖尿病高危人群的定义吗？找良医网告诉你，有这12种因素的人，每年要查一次血糖。我国有1.14亿糖尿病患者，但未诊断者有6130万人，另有糖尿病前期患者4680万人。但绝大多数人有了糖尿病症状才去就诊。

\"糖尿病高危人群的定义\" 

而相关研究表明，36%的新诊糖尿病患者已经伴有微血管病变，22%严重心血管病患者存在未确诊糖尿病。为了做好早筛查早治疗，降低糖尿病的并发症和死亡率，7月11日，《基层2型糖尿病筛查专家共识》在京正式发布。共识建议糖尿病高危人群每年筛查1次；无糖尿病危险因素者每3年筛查1次。

 

其中所谓的高危人群，为具有下列任何1项及以上糖尿病危险因素的成人：

 

1、年龄≥40岁。

 

2、有糖尿病前期（糖耐量受损、空腹血糖受损或二者共存）史。

 

3、超重（BMI≥24 kg/m2）或肥胖（BMI≥28 kg/m2）和（或）中心性肥胖（男性腰围≥90 cm，女性腰围≥85 cm）。

 

4、静坐生活方式。

 

5、一级亲属中有2型糖尿病家族史。

 

6、有妊娠糖尿病或巨大儿（出生体重≥4 kg）生产史的女性。

 

7、高血压[收缩压≥140 mmHg和（或）舒张压≥90 mmHg]，或正在接受降压治疗。

 

8、血脂异常[高密度脂蛋白胆固醇≤0.91 mmol/L和（或）甘油三酯≥2.22 mmol/L]，或正在接受调脂治疗。

 

9、动脉粥样硬化性心血管疾病患者。

 

10、有一过性类固醇糖尿病病史者。

 

11、多囊卵巢综合征患者或伴有与胰岛素抵抗相关的临床状态（如黑棘皮征等）。

 

12、长期接受抗精神病药物和（或）抗抑郁药物治疗及他汀类药物治疗的患者。               

\"糖尿病高危人群的定义\" 

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":"3","topicThemeId":"1036","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1585,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1563268181240,"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":1563268181240,"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":"26010","isDel":0,"createAt":1563267794274,"createBy":"425fdc1d2e6111e8a3d800163e04584d","createName":"求一红颜笑看余生","updateAt":0,"updateBy":null,"updateName":null,"userId":"425fdc1d2e6111e8a3d800163e04584d","title":"散步有助于控制血糖吗","content":"

很多高血糖患者都问过，散步有助于控制血糖吗？其实，可以这么说，在晚饭后走20分钟可降低餐后高血糖，并且不增加夜间低血糖风险。餐后有高血糖的人，糖尿病并发症风险增加。管理好餐后高血糖，是糖尿病治疗的重要目标。

\"散步有助于控制血糖吗\" 

我国居民习惯于晚饭后锻炼身体，糖尿病患者餐后运动对血糖水平的影响还不清楚。

 

南京第一医院学者研究发现，对于有2型糖尿病的人，如果在晚饭后在跑步机上走20分钟，可以改善餐后高血糖和血糖波动，且没有夜间低血糖风险。

 

跑步机上走20分钟属于短时间的中等强度运动。

 

研究显示，餐后中等强度运动可降低餐后2小时血糖峰值、平均血糖水平和峰值血糖水平。

 

特别是晚餐后走20分钟后的血糖水平比不运动时的血糖水平低，但其影响仅限于晚餐后2小时。

 

而且，饭后20分钟的运动可以进一步改善血糖波动，且不会增加夜间低血糖发作。

 

研究纳入29例2型糖尿病患者，受试者正常服用口服降糖药，并遵循标准化的饮食，确保每天总能量摄入量为105 kJ/kg·d，包括55%的碳水化合物能量、18%的蛋白质能量和27%的脂肪能量，每天7:00、11:30和17:00时进餐。

 

受试者按交叉顺序进行了两个实验阶段的试验：1个非运动日作为对照，1个餐后运动日。参与者在非运动日的20分钟运动时段休息。在非运动日，要求参与者不要进行中-重度运动。               

\"散步有助于控制血糖吗\" 

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","barId":"1935","topicTypeId":"3","topicThemeId":"1036","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1643,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1563267794275,"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":1563267794275,"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":"25853","isDel":0,"createAt":1561619386755,"createBy":"425fdc1d2e6111e8a3d800163e04584d","createName":"求一红颜笑看余生","updateAt":0,"updateBy":null,"updateName":null,"userId":"425fdc1d2e6111e8a3d800163e04584d","title":"糖尿病人血糖控制不好会怎么样","content":"

糖尿病人要严格的控制血糖，但也有很多的糖友不重视，这样造成了更坏的结果，那么，糖尿病人血糖控制不好会怎么样？本文找良医网为大家解答一下。

\"糖尿病人血糖控制不好会怎么样\" 

Q：糖尿病人血糖控制不好会怎么样？

 

A：糖尿病患者不控制血糖或血糖控制不佳会导致各种急性并发症、慢性并发症，最终致残致死。

 

糖尿病的急性并发症包括糖尿病酮症酸中毒和高血糖高渗状态，是由于血糖过高所致，急性发病，症状严重，患者多会及时就诊。若不及时纠正，死亡率高。

 

更常见的是糖尿病慢性并发症，包括心脑血管疾病、糖尿病肾病、糖尿病视网膜病变、糖尿病神经病变、下肢动脉疾病、糖尿病足等。糖尿病对心、脑、肾、眼等重要脏器的损伤是隐秘的，常常没有什么症状，但一旦出现症状可能已经产生了不可逆转的重要脏器损伤，甚至致残致死的后果。

 

控制好血糖能显著降低各种并发症的发生率。     

 \"糖尿病人血糖控制不好会怎么样\"

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","barId":"1935","topicTypeId":"3","topicThemeId":"1036","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1497,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1561619386759,"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":1561619386759,"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":"25608","isDel":0,"createAt":1558529096714,"createBy":"84404015eff611e6a61c00163e04584d","createName":"13911686944","updateAt":0,"updateBy":null,"updateName":null,"userId":"84404015eff611e6a61c00163e04584d","title":"糖尿病血脂血压控制目标","content":"

糖尿病患者最大的威胁就是心脑血管疾病(如冠心病、心肌梗死、脑梗死等)。因此，防治心脑血管疾病是糖尿病患者的首要任务。那么病血脂血压控制目标多少合适，生活方式应该注意哪些呢？

 \"糖尿病血脂血压控制目标\"

生活方式管理

主要内容包括合理饮食、适量运动、控制体重、限制饮酒、戒烟等。首先，合理的饮食结构与总热量摄入不仅是降糖治疗的基石，也是降低心血管系统整体风险水平的有效措施，因而适用于所有糖尿病患者。对于肥胖的患者，应以低碳水化合物、低脂肪饮食为主。其次，适量运动有助于控制体重、改善糖代谢和脂代谢状态并降低血压水平，对心血管系统具有有益影响。建议糖尿病患者坚持规律性的中等强度有氧运动（例如快步行走、太极拳、自行车运动等）。体重在正常范围者每日运动时间不少于30分钟，每周不少于5天。超重/肥胖者需要增加运动量，每日运动时间不少于1小时，每周不少于5天。若无禁忌证，应鼓励患者每周进行2-3次阻抗训练（如俯卧撑、仰卧起坐、下蹲运动、举哑铃等）。第三，吸烟可以增高不良心血管事件的危险性，因此吸烟者应努力戒烟。

 

血压管理

当糖尿病患者血压水平高于130/80 mmHg时，其不良心血管事件发生率将显著增高，因此多数患者的血压应控制在此水平以下。但是对于高龄、一般健康状况较差或已经发生严重心脑血管疾病的患者，过于严格的血压控制可能会对患者产生不利影响，将血压控制在140/90 mmHg以下就可以了。降压药物可以首选普利类或沙坦类，血压不能达标时可以联合应用地平类或利尿剂等。将血压控制在130/80 mmHg以下可以显著降低心梗、脑梗的发生率！

 

血脂管理

对于已经发生心脑血管疾病的患者，无论其血脂水平如何，均应接受他汀治疗，将低密度脂蛋白胆固醇（LDL-C）控制在1.8mmol/L以下。没有心脑血管疾病但年龄≥40岁的患者，虽然其血脂水平不高也应该服用他汀类药物，将LDL-C控制于2.6 mmol/L以下。换言之，多数2型糖尿病患者需要接受他汀治疗。控制胆固醇并维持胆固醇在比较低的水平是预防心梗脑梗的重要且有效的措施！

 

抗血小板治疗

若无禁忌证，所有合并心脑血管疾病的患者均应服用小剂量阿司匹林（75-150 mg/d）。具有使用阿司匹林适应证但不能耐受治疗者，可应用氯吡格雷替代（75 mg/d）。无心脑血管疾病的50岁以上男性与60岁以上女性患者且伴有至少1项其他危险因素（吸烟，高血压，血脂异常，早发冠心病家族史，蛋白尿）者，若其不存在出血性并发症的高危因素（既往有胃肠道出血史或消化性溃疡病史，或正在服用非甾体类抗炎药物或华法林等增加出血风险的药物），也建议服用小剂量（75-150 mg/d）阿司匹林。

 

最后需要强调的是，糖尿病患者的药物治疗必须在正规医院医生指导下进行，切忌擅自购药或自行更改治疗方案

 \"糖尿病血脂血压控制目标\"

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","barId":"1935","topicTypeId":"3","topicThemeId":"1036","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1507,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1558529096715,"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":1558529096715,"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":"25558","isDel":0,"createAt":1558102063784,"createBy":"84404015eff611e6a61c00163e04584d","createName":"13911686944","updateAt":0,"updateBy":null,"updateName":null,"userId":"84404015eff611e6a61c00163e04584d","title":"生活中如何预防三高的发生","content":"

人类健康有一多半是由基因决定的，对此我们无能为力。还有一少半是后天造就的，生活中如何预防三高的发生呢？即便我们的基因注定我们在较早的年龄就会出现黄褐斑、眼袋与皱褶，只要我们平时注重防护风吹日晒，保证睡眠充足，保持轻松愉悦心情，增强运动锻炼，是完全可以推迟这些衰老征兆的发生的。反之，若只依赖于那些技术手段，则难以取得理想效果。

 

其实血压、血脂、血糖又何尝不是如此！对于我们多数健康人而言，青春年少时我们的血压、血脂、血糖都很好，我们的血管都很健康，我们的心脑肾都很安全。但是，随着我们步入中年乃至老年阶段，一系列的问题就来了：血压高了，血脂高了，血糖高了，随之就会逐渐发生心脑肾疾病。

 \"生活中如何预防三高的发生\"

发生这些问题后，很多人开始慌乱了：血压高了，赶紧找医生开降压药！血糖高了，赶紧吃降糖药！血脂高了，赶紧吃降脂药！心梗脑梗肾衰了，赶紧住院治疗！这么做对吗？当然对，身体出现问题一定要及时恰当的进行治疗，避免出现更严重的后果。但是治疗效果呢？你固然可以通过药物把血压血脂血糖统统控制在正常水平，但是你的身体健康能够恢复到以前的样子吗？不会！不仅不会，甚至还可能更糟！

 

例如，两个50岁的中年大叔，一个人平时保持着良好的生活习惯，血压一致维持在110/70 mmHg，他会非常健康的，他的血管、他的心脑肾都比较安全；但是另一个大叔，一直过着很油腻的生活，多年前就发生了高血压，血压经常在180/100mmHg左右却从未治疗。终于有一天他认识到了健康的重要性，服用多种药物把血压强行降至110/70 mmHg。他的心脑肾会跟另一位大叔同样健康吗？不会的！因为自然状态下的血压与药物控制的血压临床意义是不一样的。油腻大叔把血压降到110/70mmHg不仅不会完全恢复健康，甚至还会对身体产生不利影响。

 

又如两位大妈，都是50岁，一个人平时健康意识很强，空腹血糖一直维持在4-5mmol/L之间，很健康的！另一个油腻大妈，天天胡吃海喝彻夜打牌不运动，检查才得知自己早已发生了糖尿病。赶紧治疗吧，赶紧吃降糖药吧！亲爱的大妈，您千万不要把血糖降到另一位健康大妈那个水平，人家空腹血糖4-5之间是很健康的，但您若是降到那么低有可能会发生严重后果、甚至会要命的！

 

发生高血压、糖尿病后积极接受药物治疗是很重要并且很必要的，但千万不要奢望这些药物能给你找回全部健康。最安全最可靠的方法是在没有发生这些疾病的时候就开始注意预防这些疾病，从青年时期、甚至少年儿童时期就要养成健康的生活习惯，始终把你的血压维持在120/80 mmHg以下，始终把你的空腹血糖维持在5.6 mmol/L以下，始终把你的低密度脂蛋白胆固醇维持在2.6 mmol/L以下，始终把你的甘油三酯维持在1.7 mmol/L以下，始终保持你的体重和腰围不超标……。这样的你才是真正健康的你！

 

涂抹BB霜、面膜、拉皮、打玻尿酸可以让你看上去年轻，使用降压药、降糖药可以使你的血压血糖更好，但是这只是亡羊补牢的手段。毕竟丢掉的羊很难再找回来了，已经失去的健康也很难通过药物治疗补救回来。所以，最好的办法就是经常检修维护羊圈，尽量不让它损坏……。

\"生活中如何预防三高的发生\"

下载二维码，微信识别，观看丁荣晶教授主讲三小时的《心肌梗死与心肌康复》

\"生活中如何预防三高的发生\"

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","barId":"1935","topicTypeId":"3","topicThemeId":"1036","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1417,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1558102063785,"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":1558102063785,"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":"1731","isDel":0,"createAt":1486387301598,"createBy":"6aad1b12ea7211e6a61c00163e04584d","createName":"茉莉花","updateAt":0,"updateBy":null,"updateName":null,"userId":"6aad1b12ea7211e6a61c00163e04584d","title":"糖尿病性视网膜病变怎么防治","content":"

\"845630426.jpg\"

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本病可采用光凝治疗：主要适用于国际分级标准第4级，过早激光治疗弊大于利。根据治疗目的不同，糖尿病性视网膜病变各期的光凝方法也不同。黄斑水肿可采用氩激光做局部格栅样光凝。增殖前期，视网膜出血和棉絮状斑增多，广泛微血管异常，毛细血管无灌注区增加，提示有产生新生血管进入增生期的危险时，应做全视网膜光凝，防止发生新生血管。如果视网膜和（或）视盘已有新生血管，则应立即做全视网膜光凝，以防止新生血管出血和视力进一步下降。玻璃体切割术常用于大量玻璃体积血和（或）有机化条带牵拉致视网膜脱离。手术的目的是清除浑浊的玻璃体，缓解玻璃体视网膜牵拉，封闭裂孔，使脱离视网膜复位。全身治疗方面首先应控制血糖，采用饮食控制或联合降糖药物。长期稳定地控制血糖能延缓糖尿病性视网膜病变的发展，短时间内快速降低血糖，反而会加重糖尿病性视网膜病变。导升明（国产药名多贝斯）：可降低毛细血管通透性，降低血黏度，减少红细胞和血小板聚集及其释放反应。预防用药，500mg/日，分1～2次服用；非增生性糖尿病性视网膜病变，750～1 500mg/日，分2～3次服用；增生性糖尿病性视网膜病变每日1 500～2 000mg，分3～4次服用。疗程为3～6个月。其他药物如口服阿司匹林、肌内注射普罗碘胺等可用于促进出血吸收。

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患者应严格、合理控制血糖、血压、血脂，调整起居、饮食，并适当运动。定期进行眼科检查，及时进行针对性治疗。治疗本病应当在西医有效控制血糖的基础上，加以中医药辨证论治。适时采用眼底激光光凝手术的中西医结合治疗方案，以提高疗效和减少失明的发生。

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　李大爷患糖尿病己有多年，由于一直自觉身体良好，基本上没有接受过正规治疗。一天散步时，李大爷脚底不小心被铁钉扎伤，找到附近的诊所进行了简单的包扎，并吃了消炎药，可一点也不见好，一周后被扎的左脚就出现了严重的感染，溃烂面越来越大，去了当地几家医院，医生的结论都是只能截肢。后来患者辗转来到南方医院内分泌代谢科，经过多位专家的会诊与研究，最后采用负压吸引、超声清创术、配置敷料等技术为患者进行治疗，半个月之后，大面积溃疡幸运痊愈，免去了截肢之苦。“只是一个小钉子，我哪知道会有这么严重啊？”现在每每谈到自己的脚，李大爷除了对南方医院的感激以外，总还会发出这样的感慨！

　　“多数糖尿病患者对糖尿病足这种并发症不够了解，直到脚部已经严重溃烂甚至面临着截肢时才到医院就诊，结果错过了最佳的治疗时间。”内分泌代谢科主任薛耀明说，“我国现有糖尿病患者约4000万，中心城市的发病率已超过10%。这些患者中有5%~20%将在其病程中出现足部溃疡或坏疽。糖尿病足病的截肢率是非糖尿病患者的15倍，每年的截肢患者中约50%是糖尿病患者，每30秒钟就有人因为糖尿病足而失去一条腿。。。”

小伤口常变大麻烦

　　“糖尿病足的诱发因素有皮肤受损、外伤或烫伤、感染等，起病时大多只是很小的伤口，及早处理可使创面得到有效控制。由于多数患者往往没能采取相应的治疗措施，因而很多糖尿病足患者面临溃疡扩大、甚至截肢的结局。上面那位李大爷就是临床上一个典型的例子。”

还有一些因动脉闭塞所引起的伤口，虽进展缓慢，但治疗起来非常棘手，如不及时检查治疗，病变部位会逐渐发黑坏死，“一旦形成的缺血性坏疽，截肢往往难以避免”。

综合治疗，内外结合

　　“没有糖尿病自然就没有糖尿病足，综合治疗、内外结合才能取得令人满意的效果，很多医院内外科分工较细，这样造成了内科只管调节，外科只管治伤口，如果病人的创面比较大，可能最后就截肢去了。”薛耀明说，对于处理糖尿病足这样一个系统工程来说，一定要强调局部和整体结合。糖尿病病人一旦出现足部的局部伤口，绝不像单纯的正常人的伤口，而是全身病变的局部表现，如果过于强调治疗局部伤口，被伤口的好坏牵着鼻子走，那么永远治不好。就整体来讲，首要的是要控制好高血糖，足部感染的发生会导致血糖控制难度的增加，多数需要使用胰岛素。血压、血脂，吸烟等可变因素的控制对伤口愈合可发挥更加积极的作用，此外，下肢浮肿的患者必须消肿，营养状况要尽力改善。

　　“90%的神经性足溃疡可以通过保守治疗而愈合”。处理神经性足溃疡的关键是要减轻原发病变造成的压力，可以通过特殊的改变压力的矫形鞋子或足的矫形器来达到改变患者足压力。根据溃疡的深度、面积大小、渗出多少以及是否合并感染来决定换药的次数和局部用药。对于一般临床医生而言，重要的是能够识别不同原因所致的不同足溃疡的特点，如神经—缺血性溃疡通常没有大量渗出，因此不宜选用吸收性很强的敷料；如合并感染，渗出较多时，敷料选择错误可以使创面浸渍，病情恶化，引起严重的后果。对于难以治愈的足溃疡，可采用些生物制剂或生长因子类物质，如血小板衍生生长因子(PDGF)、表皮生长因子(EGF)等，可用以治疗神经性足溃疡，其促进溃疡愈合的能力。

　　“对与因严重下肢缺血导致的溃疡可考虑行血管重建手术”，薛耀明说，血管置换、血管成形或血管旁路术等可能使部分患者避免截肢。已发坏疽且在休息时有疼痛及广泛的病变不能手术者，则要给予有效的截肢，尽可能在膝以下截肢。截肢前最好做血管造影，以决定截肢平面，对于血管阻塞不是非常严重或没有手术指征者，可以采取内科保守治疗，静脉滴注扩血管和改善血液循环的药物，如凯时、川芎嗪，口服阿司匹林等。一些小的趾端的坏疽偶尔在控制感染后，会自行脱落，截肢手术后的患者，要给予康复治疗，要帮助患者尽快利用假肢恢复行走，由于一侧截肢后，另一侧发生溃疡或坏疽的可能性很大，因而必须对患者加强有关足保护的教育。

　　感染是导致病灶扩大的主要原因，尤其是有骨髓炎和深部脓肿者，常需住院。这种情况下应在血糖监测的基础上强化胰岛素治疗，使血糖达到或接近正常，同时加强抗炎和积极清创。表浅组织的感染与深部组织感染处理有所不同。原则上，应在细菌培养的基础上决定用药。有时，感染为少见的不典型的细菌所致，要考虑在早期给予有效的抗菌治疗的同时，给予局部的清创。对于表浅的感染，可以采取口服广谱抗菌素，例如头孢霉素加克林霉素，不应单独使用头孢霉素或喹诺酮类药物，因为这些药物的抗菌谱并不包括厌氧菌和一些G+细菌。克林霉素可以很好地进入组织，包括很难透过的骨组织，口服治疗可以持续数周，深部感染可以用上述相同的抗菌素，但是开始时应从静脉给药，以后再口服维持用药数周（最长达12周）。在临床的基础上，结合X片来了解治疗的效果，深部感染可能需要外科引流，包括切除感染的骨组织和截肢。“多数肢体的致残是因为没有进行上述有效的治疗”。

 

早筛查 早预防

　　“糖尿病足可防可治！”薛耀明说，通过加强对有危险因素的足的预防性保护，这种截肢可以被避免或推迟，早期筛查对诊断和预防糖尿病足非常重要。

　　糖尿病发生足溃疡高度危险因素有周围神经和植物神经病变、周围血管病变、以往有足溃疡史、足畸形（如鹰爪足、Charcot足）、胼胝、失明或视力严重减退、合并肾脏病变特别是肾功能衰竭、独立生活的老年人、糖尿病知识缺乏者和不能进行有效的保护者等。定期对糖尿病患者进行早期糖尿病足筛查，对防止足溃疡及截肢的发生有重要意义。

　　10g尼龙丝检查法、40g痛觉测定、振动觉测定、皮肤温度觉测定、泌汗功能检测等，可早期发现糖尿病患者是否已存在保护性的足部神经功能缺失。踝动脉，肱动脉血压比值（ABI）是非常有价值的反映下肢血压与血管状态的指标，正常值为1.0-1.4，＜0.9为轻度缺血的，0.5~0.7为中度缺血，＜0.5为重度缺血，重度缺血的患者容易发生下肢（趾）坏疽。这些检查无创且可快速拿到结果，对早期发现病变十分有益。

　　“要像爱惜自己的眼睛一样爱惜自己的脚！”薛耀明主任给糖尿病患者提出了这样的建议。“一旦被确诊患有糖尿病，就应开始预防溃疡和截肢，每年应到医院做一次足部健康检查，如果有并发症，则应每季度检查一次，特别是有过足溃疡和曾经因糖尿病截肢的患者，应1～3月检查一次。平常应保持健康的生活方式，积极控制血糖，加强对足部的护理，从生活的细节、小处入手，包括每天的洗脚、剪指甲、选鞋、选袜子等等。一旦出现下肢不适，切莫贻误了治疗。”


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我们日常活动、工作生活、甚至乘船、开车，每时每刻都离不开脚的支撑。可能很少有人想象：一旦我们没了“脚”，会是什么结果？……
　　可是，残酷的现实是：很多种疾病都有导致丧失肢体的危险，比如：血栓闭塞性脉管炎、动脉硬化闭塞症、糖尿病足、动脉栓塞、多种血管炎等，下面，我们就重点介绍一下我们最熟悉的糖尿病并发症：糖尿病足。 
    糖尿病是危害人类健康的常见病、多发病，“糖尿病足”是糖尿病病人的严重脚部并发症，据世界卫生组织、欧美权威机构统计：全世界总糖尿病发病率已达3－5％！其中糖尿病足发病率达10％左右，糖尿病足截肢率占全部非创伤性截肢的一半以上，远比“脉管炎”、恶性肿瘤、动脉硬化闭塞、急性动脉栓塞截肢率高！15％～20％的糖尿病患者在其一生中将发生足溃疡或坏疽，糖尿病足病的截肢率是非糖尿病患者的15倍，所有糖尿病住院病人中，糖尿病足消费占一半以上，在我国大中城市的统计资料，平均糖尿病足住院费用10000元以上；严重加重国家、社会负担。那么应如何防治糖尿病足呢？

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　　1、  糖尿病病人应积极学习糖尿病预防保健知识，科学、合理用药，定期检查防止糖尿病足等并发症。
　　2、  科学饮食，在医生指导下合理搭配饮食结构，（主要是制定针对性的个性化饮食控制方案），达到血糖稳定达标、又不造成营养缺乏的目的。
　　3、  适当锻炼：根据患者病情轻重和并发症情况合理运动，一般以餐后30分钟开始运动，散步和慢跑为主。
　　4、  良好的心态：正确认识糖尿病，遵医嘱用药并定期检查，认识到糖尿病得到规范、及时治疗可以向正常人一样生活的道理。
　　5、  足部保护及护理：干裂足应该晚上用温水洗足后涂保湿剂；汗足应保持足部清洁，鞋袜干燥；防治胼胝、甲癣、甲周炎、甲下感染和各种皮肤损伤，应力戒过敏和刺激性强的中西药物外用，对于水泡应严格无菌抽液处理。对于老年体弱、视力不佳的糖尿病人，子女应经常关注其脚的变化，必要时定期找有关专家诊视，才能防止“一失足成千古恨”！

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“千里之行，始于足下”
“一‘失足’成千古恨”
为避免或延缓“失足”的进程，对糖尿病足患者采取科学规划膳食，加强血糖监测，严格控制血糖，从根源上遏制糖尿病足的发生、发展。
在日常生活中，选择鞋袜不当是引起糖尿病足溃疡的主要原因。因此，不能穿尺码偏小的鞋、硬底鞋、高跟鞋。选鞋子不应太紧或太松，应讲究宽松、柔软、透气、内衬平展，其内部应比脚的本身长1~2厘米，宽度与跖趾关节部位的足宽度相等，高度考虑给足趾充分空间。同时，尽量穿棉布袜，袜边不要太紧，以免袜口勒出印痕磨损皮肤。
糖尿病足患者不可用热水泡脚，泡脚时温度应低于37摄氏度，并适当用双脚按摩互搓，促进足底血液循环。洗脚擦干后，用剪刀小心地修整趾甲，并把边缘磨光滑。若是脚上长了鸡眼、老茧，千万别自行修剪，一定要去医院找医生处置。
夏季最多的糖尿病并发症就是糖尿病足，因为天气温暖、炎热，光脚的机会较多，脚部容易被异物碰伤或刺伤，而且夏天蚊虫肆虐，遭到叮咬后，皮肤易出现瘙痒，再加上大量出汗，患足被抓破后更易感染，从而使糖尿病足病情加重。还应注意的是，在天气寒冷时，不可使用热水袋或热水瓶暖脚，以避免被烫伤，可用厚袜套或毛毯来保温。对于干燥的皮肤，应使用润滑剂或护肤软膏，但不能用在脚趾之间。
因糖尿病足患者的脚部感觉迟钝，受到损伤后常常不自觉，特别提醒高危病人每天查看足部，确认有无裂伤或局部红肿感染，如有要及时就医。

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运动疗法是治疗糖尿病的五架马车之一，通过运动可以控制体重、减轻胰岛素抵抗、降低血糖。但糖尿病足患者运动时需要特别注意 。

适合糖尿病患者的运动方式有很多重，比如：散步、跑步、打球、游泳、登山等，但如果是糖尿病足患者，则需要谨慎决定是否采取运动疗法。


适当的运动可以改善糖尿病患者下肢与足部的血液循环，但在运动时应该注意以下几点：

1、糖尿病患者在运动时应选择透气性好、颜色浅的袜子，以便能第一时间发现伤口。

2、如果足部有开放性病变、坏疽、急性溃疡合并感染等情况下，患者应卧床休息，减少走动或不走动。

3、有慢性溃疡但没有感染的患者，在配以特别定制的鞋子来保证溃疡不受压迫的情况下，可以适当的出门散散步。

4、足部有神经病变的患者在运动时，首先要选择合适的鞋，其次运动前要检查鞋内有无破损或异物，以免因为痛觉减退而导致受伤。

5、运动结束后，患者应仔细检查足部，看有无异常，如果出现伤口患者应及时到医院就诊。

6、有足部畸形的患者不宜做剧烈运动，应选择散步一类的运动。

7、患者如果在运动后出现下肢疼痛的情况，应立即停止运动，并及时到医院就诊。


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