分级诊疗模式下我国社区老年血糖管理
摘要
随着老龄化社会的到来,我国老年居民的血糖控制和糖尿病预防及综合管理为社区全科医学体系带来了机遇和挑战。本文将从糖尿病的预防、分层的血糖目标制定、血糖管理策略和互联网+时代社区老年血糖控制所可能面临的巨大变革进行了简要阐述。
引文
[1]中华人民共和国国家统计局.2018年国民经济和社会发展统计公报[R/OL].(2019-02-28)[2019-03-22]. http://www.stats.gov.cn/tjsj/zxfb/201902/t20190228_1651265.html
[2] Wang L, Gao P, Zhang M, et al. Prevalence and ethnic pattern of diabetes and prediabetes in China in 2013[J].JAMA, 2017,317(24):2515-2523.
[3] GBD 2017 Mortality Collaborators. Global, regional, and national age-sex-specific mortality and life expectancy,1950-2017:a systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet, 2018,392:1684-1735.
[4] Holman RR, Paul SK, Bethel MA, et al. 10-year followup of intensive glucose control in type 2 diabetes[J]. N Engl J Med, 2008,359(15):1577-1589.
[5] White NH, Sun W, Cleary PA, et al. Prolonged effect of intensive therapy on the risk of retinopathy complications in patients with type l diabetes mellitus:l0-years after the diabetes control and complications trial[J]. Arch Ophthalmol, 2008,126(12):1707-1715.
[6]中国老年学学会老年医学会老年内分泌代谢专业委员会,老年糖尿病诊疗措施专家共识编写组.老年糖尿病诊疗措施专家共识(2013年版)[J].中华内科杂志,2014,53(3):243-251.
[7]中国疾病预防控制中心,中国疾病预防控制中心慢性非传染性疾病预防控制中心.中国慢性病及其危险因素监测报告2013[M].北京:军事医学出版社,2016:5.
[8]中华医学会内分泌学分会.中国成人2型糖尿病预防的专家共识[J].中华内分泌代谢杂志,2014,30(4):277-283.
[9] Forouhi NG,Misra A, Mohan V, et al. Dietary and nutritional approaches for prevention and management of type 2diabetes[J]. BMJ, 2018,361:k2234.
[10]程改平,李舍予,胡雯.2018年《英国基于证据的预防管理糖尿病营养指南》解读[J].中国全科医学,2018,21(17):2017-2021.
[11] International Diabetes Federation. Managing older people with Type 2 Diabetes Global Guideline[R]. IDF, 2013.
[12]中华医学会糖尿病学分会,国家基层糖尿病防治管理办公室.国家基层糖尿病防治管理指南(2018)[J].中华内科杂志,2018,57(12):885-893.
[13] Clinical Guidelines Committee of the American College of Physicians. Hemoglobin A1c Targets for Glycemic Control With Pharmacologic Therapy for Nonpregnant Adults With Type 2 Diabetes Mellitus:A Guidance Statement Update From the American College of Physician[J]. Ann Intern Med, 2018,168(8):569-576.
[14] Hambling CE, Khunti K, Cos X, et al. Factors influencing safe glucose-lowering in older adults with type 2 diabetes:A PeRsOn-centred ApproaCh To IndiVidualisEd(PROACTIVE)Glycemic Goals for older people:A position statement of Primary Care Diabetes Europe[J]. Prim Care Diabetes, 2019,pii:S1751-9918(18)30300-0.[Epub ahead of print]
[15] Strain WD, Hope SV, Green A, et al. Type 2 diabetes mellitus in older people:a brief statement of key principles of modern day management including the assessment of frailty. A national collaborative stakeholder initiative[J].Diabet Med, 2018,35(7):838-845.
[16]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017)[J].中华糖尿病杂志,2018,10(1):4-67.
[17]中华老年医学学会老年内分泌代谢分会,国家老年疾病临床医学研究中心(解放军总医院),中国老年糖尿病诊疗措施专家共识编写组.中国老年2型糖尿病诊疗措施专家共识(2018年版)[J].中华内科杂志,2018,57(9):626-641.
[18] American Diabetes Association. Improving Care and Promoting Health in Populations:Standards of Medical Care in Diabetes-2019[J]. Diabetes Care, 2019,42(Suppl 1):S7-S12.
[19]李舍予.2018年AACE/ACE《2型糖尿病综合管理策略》更新与解读[J].中国全科医学,2018,21(18):2148-2151.
[20]张良,陈晓荣,左慧娟,等.社区糖尿病患者卫生服务利用现状研究[J].中国慢性病预防与控制,2015,23(4):285-287.
[21] Hart HE, Rutten GE, Bontje KN, et al. Overtreatment of older patients with type 2 diabetes mellitus in primary care[J]. Diabetes Obes Metab, 2018,20(4):1066-1069.
[22]国务院办公厅.国务院办公厅关于促进“互联网+医疗健康”发展的意见[R/OL].2018-04-28.[2019-03-22].http://www.gov.cn/zhengce/content/2018-04/28/content_5286645.htm
[23] Wei X, Wu H, Cui S, et al. Intelligent Internet-based information system optimises diabetes mellitus management in communities[J]. Health Inf Manag, 2018,47(2):70-76.
[24] Contreras I, Vehi J. Artificial Intelligence for Diabetes Management and Decision Support:Literature Review[J].J Med Internet Res, 2018,20(5):e10775.
[25] Gloyn AL, Drucker DJ. Precision medicine in the management of type 2 diabetes[J]. Lancet Diabetes Endocrinol,2018,6(11):891-900.
[2] Wang L, Gao P, Zhang M, et al. Prevalence and ethnic pattern of diabetes and prediabetes in China in 2013[J].JAMA, 2017,317(24):2515-2523.
[3] GBD 2017 Mortality Collaborators. Global, regional, and national age-sex-specific mortality and life expectancy,1950-2017:a systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet, 2018,392:1684-1735.
[4] Holman RR, Paul SK, Bethel MA, et al. 10-year followup of intensive glucose control in type 2 diabetes[J]. N Engl J Med, 2008,359(15):1577-1589.
[5] White NH, Sun W, Cleary PA, et al. Prolonged effect of intensive therapy on the risk of retinopathy complications in patients with type l diabetes mellitus:l0-years after the diabetes control and complications trial[J]. Arch Ophthalmol, 2008,126(12):1707-1715.
[6]中国老年学学会老年医学会老年内分泌代谢专业委员会,老年糖尿病诊疗措施专家共识编写组.老年糖尿病诊疗措施专家共识(2013年版)[J].中华内科杂志,2014,53(3):243-251.
[7]中国疾病预防控制中心,中国疾病预防控制中心慢性非传染性疾病预防控制中心.中国慢性病及其危险因素监测报告2013[M].北京:军事医学出版社,2016:5.
[8]中华医学会内分泌学分会.中国成人2型糖尿病预防的专家共识[J].中华内分泌代谢杂志,2014,30(4):277-283.
[9] Forouhi NG,Misra A, Mohan V, et al. Dietary and nutritional approaches for prevention and management of type 2diabetes[J]. BMJ, 2018,361:k2234.
[10]程改平,李舍予,胡雯.2018年《英国基于证据的预防管理糖尿病营养指南》解读[J].中国全科医学,2018,21(17):2017-2021.
[11] International Diabetes Federation. Managing older people with Type 2 Diabetes Global Guideline[R]. IDF, 2013.
[12]中华医学会糖尿病学分会,国家基层糖尿病防治管理办公室.国家基层糖尿病防治管理指南(2018)[J].中华内科杂志,2018,57(12):885-893.
[13] Clinical Guidelines Committee of the American College of Physicians. Hemoglobin A1c Targets for Glycemic Control With Pharmacologic Therapy for Nonpregnant Adults With Type 2 Diabetes Mellitus:A Guidance Statement Update From the American College of Physician[J]. Ann Intern Med, 2018,168(8):569-576.
[14] Hambling CE, Khunti K, Cos X, et al. Factors influencing safe glucose-lowering in older adults with type 2 diabetes:A PeRsOn-centred ApproaCh To IndiVidualisEd(PROACTIVE)Glycemic Goals for older people:A position statement of Primary Care Diabetes Europe[J]. Prim Care Diabetes, 2019,pii:S1751-9918(18)30300-0.[Epub ahead of print]
[15] Strain WD, Hope SV, Green A, et al. Type 2 diabetes mellitus in older people:a brief statement of key principles of modern day management including the assessment of frailty. A national collaborative stakeholder initiative[J].Diabet Med, 2018,35(7):838-845.
[16]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017)[J].中华糖尿病杂志,2018,10(1):4-67.
[17]中华老年医学学会老年内分泌代谢分会,国家老年疾病临床医学研究中心(解放军总医院),中国老年糖尿病诊疗措施专家共识编写组.中国老年2型糖尿病诊疗措施专家共识(2018年版)[J].中华内科杂志,2018,57(9):626-641.
[18] American Diabetes Association. Improving Care and Promoting Health in Populations:Standards of Medical Care in Diabetes-2019[J]. Diabetes Care, 2019,42(Suppl 1):S7-S12.
[19]李舍予.2018年AACE/ACE《2型糖尿病综合管理策略》更新与解读[J].中国全科医学,2018,21(18):2148-2151.
[20]张良,陈晓荣,左慧娟,等.社区糖尿病患者卫生服务利用现状研究[J].中国慢性病预防与控制,2015,23(4):285-287.
[21] Hart HE, Rutten GE, Bontje KN, et al. Overtreatment of older patients with type 2 diabetes mellitus in primary care[J]. Diabetes Obes Metab, 2018,20(4):1066-1069.
[22]国务院办公厅.国务院办公厅关于促进“互联网+医疗健康”发展的意见[R/OL].2018-04-28.[2019-03-22].http://www.gov.cn/zhengce/content/2018-04/28/content_5286645.htm
[23] Wei X, Wu H, Cui S, et al. Intelligent Internet-based information system optimises diabetes mellitus management in communities[J]. Health Inf Manag, 2018,47(2):70-76.
[24] Contreras I, Vehi J. Artificial Intelligence for Diabetes Management and Decision Support:Literature Review[J].J Med Internet Res, 2018,20(5):e10775.
[25] Gloyn AL, Drucker DJ. Precision medicine in the management of type 2 diabetes[J]. Lancet Diabetes Endocrinol,2018,6(11):891-900.