预防糖尿病的问题与展望

Preventing diabetes:problems and prospects

糖尿病的患病率已达到流行的程度,其并发症是导致糖尿病患者致死致残的重要原因。且一旦发展成显性糖尿病,目前还不能治愈,这给世界卫生保健体系带来巨大的压力。现有的研究也证明了糖尿病是可以预防的,但在预防过程中还有许多问题没有解决。文章讨论了目前糖尿病预防措施的不足,分析了中医学在糖尿病预防中的作用及优势,并提出了在生活方式干预的基础上,辅以中医药疗法可能是预防糖尿病的最好预防措施;另外,今后的研究应持续更长的时间,以区分究竟是真正预防了糖尿病的发生,还是只是延缓或是掩盖了糖尿病的发生。

The prevalence of diabetes is reaching epidemic proportions worldwide. Elevated glucose levels and associated increases in blood pressure and dyslipidemia lead to long-term complications including cardiovascular disease, diabetic retinopathy, kidney disease, and nervous system damage. These complications are largely responsible for the great increase in morbidity and mortality seen in diabetes. Unfortunately, once established, diabetes is very difficult to treat, and it is currently exerting tremendous pressure on healthcare systems worldwide. For these reasons, diabetes prevention has become a key target for clinicians, patients and policymakers, and a number of potential strategies are under study. The purpose of this article is first to discuss the deficiency of current preventing strategies, and the potential role and the advantages of Traditional Chinese Medicine （TCM） to prevent diabetes. Following that, based on observational studies as well as on prospective trials, and with respect to the prevention and treatment of diabetes, the authors, therefore, suggest that the best way to approach prevention is through lifestyle modification guided by TCM theory. And those interventions should include not only herbs, but acupuncture, massage, food therapy and mind-body exercise, and they must examine cost-effectiveness as well. Future studies should also be designed with using such interventions and should be of sufficient duration to differentiate between genuine diabetes prevention as opposed to simple delay or masking of the disease.