血糖控制目标是否越接近正常越好

The target of glycemic control:more close to normal level,the better.

DCCT、UKPDS及Steno-2研究的后续随访均发现,原强化治疗组在减少微血管病变和大血管病变风险方面持续获益,提示早期强化血糖控制使糖尿病患者获益最大。另一方面,ACCORD研究显示,在高危的2型糖尿病患者中,强化降糖治疗使全因死亡风险增高。因此,血糖控制的目标值应个体化,不但要重视强化降糖,更要保证降糖过程中不出现低血糖反应。

In post-trial follow-up of DCCT, UKPDS and Steno-2 studies, sustained beneficial effects on the risk reductions for microvascular and macmvascular complications has been observed in previous intensive treatment group, suggesting that patients with diabetes benefit mostly from early intensive blood glucose control. On the other hand, intensive glucose lowering therapy has been shown to increase the risk of all cause mortality in high-risk patients with type 2 diabetes in ACCORD study. Therefore, the target of blood glucose control should be individualized for each diabetic patient. Not only intensive glucose lowering therapy but also avoidance of hypoglycemia during therapy should be highly considered.