小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 无症状
- 多饮
- 多尿
其他诊断因素
- 念珠菌感染
- 皮肤感染
- 泌尿道感染
- 疲劳
- 视力模糊
- 多食
- 非故意的体重下降
- 感觉异常
- 黑棘皮症
危险因素
- 老年
- 超重/肥胖
- 妊娠期糖尿病
- 非糖尿病性高血糖
- 2 型糖尿病家族史
- 非白人血统
- 多囊卵巢综合征
- 高血压
- 血脂异常
- 心血管疾病
- 压力
诊断性检查
首要检查
- 空腹血糖
- HbA1c
- 口服 75 g 葡萄糖后 2 小时的糖耐量
- 随机血糖
需考虑的检查
- 空腹血脂检查
- 尿酮
- 白蛋白与肌酐比值(ACR)
- 血清肌酐和估算的肾小球滤过率
- 心电图(ECG)
- 踝肱指数(ABPI)
- 随机 C 肽
- 自身抗体检查
- 肝功能检测
治疗流程
初步诊断
耐受且不禁用二甲双胍:非妊娠
二甲双胍禁用或不耐受:非妊娠
妊娠
撰稿人
作者
Amar Puttanna, MBChB, MRCP
Diabetes and Endocrinology Consultant
Good Hope Hospital
University Hospitals Birmingham NHS Trust
UK
利益声明
AP has received honoraria from Napp, Novo Nordisk, Sanofi, Lilly-Boehringer Ingelheim, Daiichi-Sankyo, and AstraZeneca for presentation at meetings, conference registration or participating in advisory boards.
Partha Kar, OBE, MBBS MD, FRCP
Consultant Endocrinologist
Portsmouth Hospitals University NHS Trust
National Specialty Advisor, Diabetes, NHS England
UK
利益声明
PK has sat on advisory boards and attended events reimbursed by Novo Nordisk, Eli Lilly, and Sanofi.
鸣谢
Dr Amar Puttanna and Dr Partha Kar would like to gratefully acknowledge Dr Patrick J. O'Connor and Dr JoAnn M. Sperl-Hillen, the previous contributors to this topic.
利益声明
PJO receives research funding from the National Institutes of Health on multiple projects and is an author of a number of references cited in this topic. JMS-H is an author of a number of references cited in this topic and is an inventor on a US patent for Disease Treatment Simulation, a simulation-based technology developed without commercial support to educate health providers on chronic disease management in a virtual environment.
同行评议者
Vinod Patel, MD, FRCP, FHEA, MRCGP, DRCOG, MBChB, BSc (Hons), RCPathME
Professor, Diabetes and Clinical Skills
Warwick Medical School
University of Warwick
Hon Consultant in Endocrinology and Diabetes, Acute Medicine, Medical Obstetrics
Diabetes and Endocrinology Centre
George Eliot Hospital NHS Trust
Nuneaton
Clinical Director for Diabetes West Midlands Clinical Networks & Clinical Senate
NHS England and NHS Improvement - Midlands
UK
利益声明
VP declares he has worked with most of the large pharmaceutical industry groups over the years with the majority of the work being in education of healthcare professionals in diabetes care. This includes Novo Nordisk, Eli Lily, MSD, BI, Sanofi, Napp, Internis, Takeda, and AZ. VP has been part of advisory board work on occasions. VP has received conference arrangements and lecture fees. VP is a trustee of the charity South Asian Health Foundation.
Gregory Lip, MD, FRCP, DFM, FACC, FESC, FEHRA
Price-Evans Professor of Cardiovascular Medicine
University of Liverpool
Senior Investigator
National Institute for Health Research
UK
Distinguished Professor
Faculty of Medicine
Aalborg University
Denmark
Adjunct Professor
Yonsei University
Seoul
South Korea
利益声明
GL has acted as a consultant and speaker for BMS/Pfizer, Boehringer Ingelheim, and Daiichi-Sankyo.
鉴别诊断
- 非糖尿病性高血糖(糖尿病前期)
- 1 型糖尿病
- 成人隐匿性自身免疫糖尿病 (LADA)
更多 鉴别诊断指南
- 成人 2 型糖尿病:管理
- 糖尿病、糖尿病前期和心血管疾病的相关指南
更多 指南患者教育信息
糖尿病前期:
什么是糖尿病?
更多 患者教育信息医学计算器
用 CKD-EPI 公式估算 GFR
更多 医学计算器- 登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容
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