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目的探讨肥胖程度与糖尿病患者代谢状态及慢性并发症的关系。方法将新诊断的2型糖尿病患者以体重指数分为3组,分别比较空腹血糖及餐后血糖、血压、血脂、胰岛素抵抗指数、空腹C肽水平及大血管/微血管并发症患病率。结果低体重患者主要临床特征为胰岛素分泌水平低下,HbA_lc及空腹血糖增高。超重、肥胖的糖尿病患者主要表现为高血压、胰岛素抵抗、高甘油三酯和低高密度脂蛋白胆固醇血症。超重组易伴发高血压及冠心病等大血管病变,而低体重组微血管病变尤其是视网膜病变较为突出。结论对于初诊的低体重患者,应尽早补充胰岛素并及时筛查视网膜病变等微血管并发症;对于超重患者应强调减肥、降压、调脂等综合治疗。
Objective To investigate the relationship between obesity and metabolic status and chronic complications in diabetic patients. Methods The newly diagnosed patients with type 2 diabetes were divided into 3 groups according to body mass index. Fasting blood glucose, postprandial blood glucose, blood pressure, lipids, insulin resistance index, fasting C-peptide level and macrovascular / microvascular complications were compared. Results The main clinical features of low-weight patients were low levels of insulin secretion, HbA_lc and fasting blood glucose. Overweight, obese diabetic patients mainly manifested as hypertension, insulin resistance, high triglycerides and low-density lipoprotein cholesterol. Overweight group easily accompanied by hypertension and coronary heart disease and other macrovascular disease, and low body weight microangiopathy, especially retinal lesions are more prominent. Conclusion For newly diagnosed low-weight patients, insulin should be replenished as soon as possible and timely screening for microvascular complications such as retinopathy; for overweight patients should emphasize weight loss, blood pressure, lipid-lowering and other comprehensive treatment.