糖尿病前期 - 症状与病因 - 妙佑医疗国际

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糖尿病前期

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What is insulin resistance A Mayo Clinic expert explains

Learn about insulin resistance from Eleanna De Filippis, M.D., Ph.D., an endocrinologist at Mayo Clinic. 请参见副本供视频使用 What is insulin resistance A Mayo Clinic expert explains Hello. I'm Dr. Eleanna De Filippis, an endocrinologist at Mayo Clinic. In this video, we'll cover the basics of insulin resistance. What is it? Who gets it? The symptoms, diagnosis and treatment. Whether you're looking for answers for yourself or someone you love, we're here to give you the best information available. To understand insulin resistance, often referred to as prediabetes, let's first talk about what insulin does. When you eat food, your body converts that food into dietary sugars. Insulin is a hormone released by the pancreas that tells your cells to open up to that sugar and convert it into energy. With insulin resistance, the cells don't react, and don't open up, resulting in excessive sugar in the blood. Over time, the pancreas keeps trying to regulate the blood sugar, producing more and more insulin until it wears out and can't produce large amounts of insulin anymore. As a result, blood sugar levels increase to the point of being in the diabetic range. Who gets it? Anyone can become insulin-resistant. In particular, people with excess weight are at a higher risk, compared to the general population. Risk is further increased with a family history of type two diabetes, age over 45, African, Latino or Native American ancestry, smoking, and certain medications, including steroids, anti-psychotics, and HIV medication. There are other medical conditions associated with insulin resistance, like obstructive sleep apnea, fatty liver disease, polycystic ovarian syndrome, also known as PCOS, Cushing's syndrome, and lipodystrophy syndromes. Lipodystrophy syndromes are conditions that cause abnormal fat loss. So carrying either too much or not enough fat tissue in your body can be associated with insulin resistance. What are the symptoms? Very often people with insulin resistance don't have any symptoms at all. It is usually picked up by their doctor during an annual health exam or routine blood work. There are some signs of insulin resistance that your doctor may look for. These includes a waistline over 40 inches in men, and a waistline over 35 inches in women. Skin tags or patches of dark velvety skin called acanthosis nigricans. A blood pressure reading of 130 over 80 or higher. A fasting glucose level equal or above 100 milligrams per deciliter. Or a blood sugar level equal or above 140 milligrams per deciliter two hours after a glucose load test. An A1C between 5.7% and 6.3%. A fasting triglycerides level over 150 milligram per deciliter. And an HDL cholesterol level under 40 milligrams per deciliter in men, and an HDL cholesterol level under 50 milligrams per deciliter in women. How is it diagnosed? If your doctor spots these symptoms, they may follow up with a physical exam and a variety of blood tests that measure the levels of glucose, or sugar, in your blood and/or your tolerance to that glucose. Or more recently, a blood test called hemoglobin glycosylated A1C, often simply referred to as A1C. How is it treated? Reversing insulin resistance and preventing type two diabetes is possible through lifestyle changes, medication, or sometimes both. Healthy bodies come in different shapes and sizes. Losing weight through drastic means can be dangerous and counterproductive. Instead, get ideas from a doctor or a nutritionist about ways to incorporate healthy foods like fruits, vegetables, nuts, beans, and lean proteins into your meals. Also, consider incorporating exercise and movement into your day-to-day life in ways that make you feel good. What now? Even though permanently defeating insulin resistance isn't always possible, you can help your body to be more receptive to insulin. Listen to your body, reduce stress, give it the nutrition and activity it desires. If you'd like to learn even more about insulin resistance, watch our other related videos or visit mayoclinic.org. We wish you well. 糖尿病前期意味着您的血糖水平高于正常水平。虽然还不足以视为 2 型糖尿病，但如果不改变生活方式，糖尿病前期的成人和儿童患者将更易患 2 型糖尿病。如果您是糖尿病前期患者，糖尿病的长期损害（尤其是对心脏、血管和肾脏的损害）可能已经开始。但也有好消息。糖尿病前期向 2 型糖尿病的发展并非不可避免。食用健康食品、将身体活动作为日常生活的一部分、保持健康的体重可帮助您的血糖水平恢复正常。与有助于成人预防 2 型糖尿病相同的生活方式改变也有助于儿童血糖水平恢复正常。

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书籍：《妙佑医疗国际糖尿病饮食》书籍：《糖尿病精要》显示妙佑医疗国际的更多产品

症状

糖尿病前期通常不会出现任何体征和症状。患者有可能出现一些身体部位皮肤较暗的体征。涉及部位可能包括颈部、腋窝、肘部、膝盖和关节。预示患者已经从糖尿病前期发展到 2 型糖尿病的常见体征和症状包括：烦渴尿频过度饥饿疲劳视力模糊

何时就诊

如果您担心糖尿病，或者您注意到任何 2 型糖尿病体征或症状，请就医。如果您具有糖尿病的任何风险因素，请咨询医生是否进行血糖筛查。申请 Mayo Clinic 预约

病因

目前尚不清楚导致糖尿病前期的确切原因。但家族史和遗传似乎在其中发挥着重要作用。缺乏规律性身体活动、体重过重和腹部周围脂肪过多似乎也是重要的因素。但目前可以确定的是，糖尿病前期患者无法再正确处理糖（葡萄糖）。这会导致葡萄糖无法发挥其正常作用，而是在血液中聚积，所以无法给组成肌肉和其他组织的细胞提供能量。身体内的大部分葡萄糖都来自所摄入的食物。一旦食物被消化，葡萄糖便会进入血流。将葡萄糖从血流移动到体内细胞需要借助一种叫做胰岛素的激素。胰岛素由胃后面称作胰腺的腺体分泌而来。胰腺会在您进食期间将胰岛素输送到血液中。胰岛素在循环期间会允许葡萄糖进入细胞，并降低您血液中的葡萄糖含量。一旦血糖水平开始下降，胰腺便会减慢将胰岛素分泌到血液中的速度。如果您患有糖尿病前期，便不能够启动此过程。您的胰腺可能无法分泌充足的胰岛素，也可能是细胞对胰岛素产生抵抗并阻止更多的葡萄糖进入。所以，这会导致葡萄糖无法为细胞提供能量，而是在您的血液中聚积。

风险因素

增加 2 型糖尿病患病几率的因素也同样会增加糖尿病前期的患病风险。这些因素包括：体重。超重是导致糖尿病前期的主要风险因素。体内脂肪组织越多，尤其是位于腹部周围的肌肉和皮肤之内和之间的脂肪越多，细胞对胰岛素的抵抗越明显。腰围。腰围较大可能表明有胰岛素抵抗情况。男性腰围大于 40 英寸，女性腰围大于 35 英寸时，胰岛素抵抗的风险升高。饮食。食用红肉和加工肉类以及饮用含糖饮料与患糖尿病前期的风险升高有关。饮食中富含水果、蔬菜、坚果、全谷物和橄榄油与患糖尿病前期的风险较低有关。不活动。运动越少，患糖尿病前期的风险越大。身体活动有助于控制体重、消耗糖类为机体供能，还能让机体更有效地利用胰岛素。年龄。虽然糖尿病可以发生在任何年龄，但 45 岁后患糖尿病前期的风险增加。家族史。如果父母一方或兄弟姐妹患有 2 型糖尿病，则您患糖尿病前期的风险也会增加。种族或族裔。虽然原因尚不清楚，但某些人种更有可能出现糖尿病前期，包括黑人、西裔、美洲印第安人和亚裔美国人。妊娠期糖尿病。如果您在怀孕时患有糖尿病（妊娠期糖尿病），您和孩子罹患糖尿病前期的风险较高。如果您曾患有妊娠期糖尿病，医生将可能至少每三年检查一次您的血糖水平。多囊卵巢综合征。患有这种常见病的女性发生糖尿病前期的风险增加，多囊卵巢综合征的特征包括月经不调、毛发过多和肥胖。睡眠。患有阻塞性睡眠呼吸暂停（一种反复中断睡眠的状况）的患者发生胰岛素抵抗的风险升高。抽烟。抽烟可能增加胰岛素抵抗。吸烟者似乎腰部重量也会增加。与糖尿病前期有关的其他病症包括：高血压高密度脂蛋白（HDL）胆固醇（即“好”胆固醇）的水平低甘油三酯（血液中的一种脂肪）水平高当这些病症伴随肥胖时，它们与胰岛素抵抗有关。三种或以上这些状况的组合常叫做代谢综合征。

Metabolic syndrome

When certain conditions occur with obesity, they are associated with insulin resistance, and can increase your risk for diabetes ⸺ and heart disease and stroke. A combination of three or more of these conditions is often called metabolic syndrome: High blood pressure Low levels of HDL High triglycerides High blood sugar levels Large waist size

并发症

糖尿病前期最严重的后果是进展为 2 型糖尿病。这是因为 2 型糖尿病可以导致：高血压高胆固醇心脏疾病卒中肾脏疾病神经损伤视力问题，可能造成丧失视力截肢术糖尿病前期与未被识别的（无症状的）心脏病发作相关，并且即使您尚未进展为 2 型糖尿病，也可能损伤您的肾脏。

预防

健康的生活方式有助于您预防糖尿病前期及其发展为 2 型糖尿病，即使您有糖尿病家族史。尝试：健康饮食每周进行至少 150 分钟中等强度的体育锻炼，或每周几乎每天锻炼 30 分钟减掉过量的体重控制血压和胆固醇不吸烟

来自妙佑医疗国际员工申请 Mayo Clinic 预约诊断与治疗 March 17, 2022 打印 Share on: FacebookTwitterWeChat

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CloseWeibo 显示参考文献 American Diabetes Association. Standards of medical care in diabetes -2021. Diabetes Care. 2020; doi:10. 2337/dc21-Sint. Prediabetes ⸺ Your chance to prevent type 2 diabetes. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/basics/prediabetes.html. Accessed Oct. 18, 2021. The surprising truth about prediabetes. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/library/features/truth-about-prediabetes.html. Accessed Oct. 18, 2021. Diabetes: 12 warning signs that appear on your skin. American Academy of Dermatology Association. https://www.aad.org/public/diseases/a-z/diabetes-warning-signs. Accessed Oct. 22, 2021. Insulin resistance and prediabetes. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance. Accessed Oct. 18, 2021. Type 2 diabetes. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/type-2-diabetes. Accessed Oct. 18, 2021. Diabetes tests and diagnosis. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/tests-diagnosis. Accessed Oct. 20, 2021. Rett K, et al. Understanding prediabetes: Definition, prevalence, burden and treatment options for an emerging disease. Current Medical Research and Opinion. 2019: doi:10.1080/03007995.2019.1601455. Mahat RK, et al. Health risks and interventions in prediabetes: A review. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2019; doi:0.1016/j.dsx.2019.07.041. Wallace AS, et al. Screening and diagnosis of prediabetes and diabetes in US children and adolescents. Pediatrics. 2020; doi:10.1542/peds.2020-0265. Magge SN, et al. Evaluation and treatment of prediabetes in youth. Journal of Pediatrics. 2020; doi:10.1016/j.jpeds.2019.12.061. Physical activity guidelines for Americans. 2nd ed. U.S. Department of Health and Human Services. https://health.gov/our-work/nutrition-physical-activity/physical-activity-guidelines/current-guidelines. Accessed Oct. 18, 2021. Natural medicines in the clinical management of diabetes. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Oct. 19, 2021. About metabolic syndrome. American Heart Association. https://www.heart.org/en/health-topics/metabolic-syndrome/about-metabolic-syndrome. Accessed Oct. 20, 2021. Cigarette smoking: A risk factor for type 2 diabetes. U.S. Food and Drug Administration. https://www.fda.gov/tobacco-products/health-effects-tobacco-use/cigarette-smoking-risk-factor-type-2-diabetes. Accessed Oct. 20, 2021. Polycystic ovary syndrome. OASH Office on Women's Health. https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome. Accessed Oct. 22, 2021. Castro MR (expert opinion). Mayo Clinic. Oct. 23, 2021.