Overview

糖尿病是一个有很多后果的问题:如果你患有这种疾病， your body can no longer keep its blood sugar at a healthy level. But over time, the effects of diabetes can become much more complicated. The disease 会导致严重的，甚至危及生命的问题，从你的头到你的 toes.

过多的血糖(也称为葡萄糖)会损害血管 贯穿你全身的神经. 这可以为许多其他问题奠定基础 医疗条件:

• stroke
• heart disease
• 肾脏疾病
• 视力问题和失明
• 脚或腿的损伤

然而，对于2600万美国糖尿病患者来说，还是有好消息的 those at risk. Experts are learning more all the time about lifestyle steps 对糖尿病的控制和预防. 新的药物和设备也可以 帮助你控制血糖，预防并发症 约翰霍普金斯专家 丽塔·卡利亚尼，硕士.D.

Prevention

虽然1型糖尿病通常发生在儿童或成年早期，但它的发病时间并不长 会在以后的生活中发展吗. However, it’s not currently known what the exact 风险因素是什么，以及如何预防.

妇女可以通过保持运动和锻炼来降低患妊娠糖尿病的风险 keeping a healthy weight before they ever get pregnant, particularly if 他们还有其他患糖尿病的风险因素.

这种糖尿病你可以做a lot 预防是2型 diabetes. Usually, people first develop prediabetes before they go on to 患有全面的2型糖尿病. 如果你知道自己有糖尿病前期， making changes to your lifestyle is an important way to keep from 患上糖尿病，Kalyani说. 和你的医生谈谈 reduce risk:

减肥(哪怕一点点). 糖尿病预防计划，一项大规模的糖尿病预防研究 strategies in those at high risk for type 2 diabetes, found that 每天进行30分钟体育锻炼的参与者体重会下降 至少有7%的体重降低了他们患2型糖尿病的风险 糖尿病减少58%. How it works: Losing excess pounds through proper diet and exercise can improve the body’s ability to use insulin 更有效地处理葡萄糖.

Move more. 要保持积极的生活方式，降低患糖尿病的风险，目标是 least two and a half hours of exercise each week. 你不需要工作 out hard—even brisk walking can help, says Kalyani.

享受健康饮食. Develop an eating plan that helps you lose weight and keep it off. You may 想要和营养师一起学习健康的饮食习惯，你可以 遵循长期. 一些聪明的步骤:专注于农产品， whole grains , and lean protein 减少脂肪和红肉的摄入.

尝试医疗干预. You may need to take medication to lower your chances of developing 糖尿病，特别是如果生活方式的改变没有足够的帮助，Kalyani states. A drug that doctors often recommend in these cases for persons with prediabetes is metformin. It can help you better control your blood sugar by reducing 你的肝脏产生的葡萄糖量.

Diagnosis

Common symptoms of type 1 and type 2 diabetes include:

• 异常口渴或饥饿
• 尿频
• fatigue
• blurry vision
• weight loss

However, some people with diabetes don’t always notice symptoms, 尤其是在早期阶段.

有一段时间，检测糖尿病前期或糖尿病需要更多的时间 工作:一个医疗保健提供者取了你的血液样本，你必须这么做 either go without eating for eight hours or swallow a heavily sweetened 糖尿病检测专用饮料. 然而，较新的测试不需要 有什么特别准备吗?. 血红蛋白 A1C test measures how much glucose has attached to red blood cells in your blood. 这可以显示你过去三个月的血糖水平. An A1C of 5.7%到6%.4 percent is classified as prediabetes; 6.5 百分比或更高的是糖尿病.

Treatment

1型糖尿病患者需要定期注射 insulin. People 2型糖尿病患者 can sometimes manage it with insulin injections, non-insulin injections, pills, diet and/or exercise.

如果你患有糖尿病，你的主要任务仍然是保持你的血糖 under control. But you also have a new goal: preventing complications. 以下是如何使用许多可用的方法来保持最佳状态 health.

防止并发症. 心脏病和中风是糖尿病患者死亡的主要原因 2 diabetes. To lower your risk of these threats and other complications, 你的医生可能会提出以下建议:

• Lose weight.
• Stop smoking.
• 如果你是高危人群，定期服用阿司匹林.
• Use medications to control high blood pressure or unhealthy cholesterol.
• 让你的脚保持良好状态. 即使是小水泡或其他小水泡 injuries on your feet can grow into serious problems.

找到正确的药物. 不同的非胰岛素药物通过不同的作用降低血糖:

• They may encourage your pancreas to make more insulin.
• They can help your body respond better to insulin.
• They may mimic the action of a substance in your body called GLP-1, 哪种食物能降低餐后血糖.

你的医生可能会建议你开始只服用一种药物，然后补充 more options over time if you can’t get your blood sugar under control. However, if your A1C level—a measure of your long-term blood sugar—is especially high when you’re diagnosed, your doctor may suggest that you start taking more than one medication to control your blood sugar right away.

你可能还需要注射胰岛素来控制你的类型 在你被诊断出患有糖尿病之后. 即使你不需要接受 大多数2型糖尿病患者最终需要立即开始使用 胰岛素，Kalyani说. But don’t consider the need to start insulin a failure or setback—diabetes is a disease that can change over time and 需要新的治疗方法. 开始注射胰岛素可以更好地帮助你 manage your diabetes and lower your risk of complications.

跟踪血糖. 你的医生可能希望你定期检查你的血糖并报告 results. Ask your doctor or pharmacist to recommend a blood sugar monitor 这对你来说很容易用. 有些有背光和大量的数字 你可以更容易地看到结果，Kalyani说，有些存储多个 随时间的读数，这样你就可以从医生那里下载结果 office.

不要让你的血糖过低. Some diabetes medications can cause your blood sugar to drop too low. This problem is called hypoglycemia, and it can be serious. Know how 识别低血糖的症状(如颤抖、出汗、出汗等) confusion) and talk to your doctor about how to treat it.

了解更多有关 糖尿病的症状、诊断和治疗 in the Health Library.

Living With...

“通过适当的自我管理和良好的教育，糖尿病患者可以 过健康长寿的生活，”卡利亚尼说. “如果控制得当，应该不会 降低他们的生活质量，但需要一些调整 他们的日常生活.”

However, diabetes is a chronic disease that isn’t curable. 你需要 用你的余生来控制它，这需要时间，注意力， 好的选择. Here are a few steps you can take to enjoy a healthy life 2型糖尿病患者.

坚持你的用药计划. 人们不能很好地控制糖尿病的一个原因是因为他们没有这样做 按照医嘱服药. 你可能有很多理由 没有正确服药:

• 它们有副作用.
• You have to take a complicated array of many drugs.
• 你忘了什么时候该吃药了.
• 它们太贵了.
• You don’t like reminders that you have diabetes.
• 你没有任何症状.

Talk to your doctor if these issues—or any others—are keeping you from 正确服药. 你的医生也许能帮你找到 solutions.

建立一个医疗合作伙伴团队. 你可能需要定期检查各种医疗保健 确保你控制了你的糖尿病，降低了你的 并发症发生几率:

• 初级保健提供者
• an endocrinologist (a doctor who specializes in diabetes, usually 由您的初级保健提供者转介)
• a pharmacist
• 糖尿病教育工作者
• an eye care provider to make sure your eyes are healthy and to treat 任何与糖尿病有关的视力问题
• a podiatrist to check your feet and prevent minor problems from 越来越严重的

不要忘记你生活方式的改变. Even if you’re on one or more medications, it’s still important to eat right, exercise regularly, and watch your weight.

Research

约翰霍普金斯专家s are always striving to understand more about 糖尿病及其并发症，以及控制和预防的新方法. 一些值得关注的研究:

糖尿病增加了女性患心脏病的风险. 最近，Kalyani和她在约翰霍普金斯大学的同事们研究了糖尿病是如何 影响女性患心脏病的风险. 他们包括以下的男女 the age of 60. Among people without 男性患糖尿病的几率要高得多 比女性更容易患心脏病. 但是一旦女性发展 他们患糖尿病的风险增加了四倍，达到了与美国人相同的水平 men who had diabetes—in other words, the risk of heart disease by sex became equal.

Many with diabetes are not taking steps to preserve vision. Despite recent advances in prevention and treatment of most vision loss 约翰·霍普金斯大学的一项研究发现，只有不到一半的人患有糖尿病 患有糖尿病眼睛损伤的美国人已经意识到糖尿病和糖尿病之间的联系 disease and visual impairment, and only six in 10 had their eyes fully 在研究前一年进行的调查.

为照顾者

“护理人员在帮助人们控制糖尿病方面非常重要，” Kalyani says. “We always encourage family members to be actively involved.” If you have a loved one with diabetes, you may be able to assist with 特定的任务:

准备健康膳食. 制作和购买不会导致血糖飙升的食物.

鼓励锻炼. Invite your loved one with diabetes to get moving with you, such as on 散步和其他体育活动.

记住并提醒. Help the person remember when to take medications and remind him to do 定期检查血糖.

Keep watch. Be on the lookout for symptoms of diabetes-related complications.

参加体检. Accompany your loved one on regular doctor visits.

Definitions

A1C Test: A blood test used to diagnose and monitor diabetes. 通过测量有多少葡萄糖(也称为血糖)附着在你的红细胞中携带氧气的蛋白质上, 这个测试可以让你和你的医疗保健提供者了解你在三个月内的平均血糖水平. 正常的结果是低于5.7 percent. 如果你有2型糖尿病, 你应该每年做两次这个测试来检查你的血糖是否得到控制.

Blood glucose: 也被称为血糖，是你身体细胞的主要能量来源. 饭后血糖水平升高，不吃东西的时间越长血糖水平就越低. 你的血糖水平是衡量你血液中有多少葡萄糖的指标. 正常的空腹血糖水平在70到100毫克/分升之间(毫克/分升血液)。.

胰岛素(in-suh-lin): 一种由胰腺细胞产生的激素. Insulin helps your body store the glucose (sugar) from your meals. 如果你有糖尿病，你的胰腺不能产生足够的这种激素, 医生可能会给你开一些药物，帮助你的肝脏制造更多的胰岛素，或者让你的肌肉对可用的胰岛素更敏感. If these medicines are not enough, you may be prescribed insulin shots.

Lean protein: Meats and other protein-rich foods low in saturated fat. These include boneless skinless chicken and turkey, 特瘦绞牛肉, beans, 脱脂酸奶, seafood, tofu, 豆豉和精瘦的红肉, 比如圆牛排和烤肉, 上里脊和上里脊. 选择这些可以帮助控制胆固醇.

Prediabetes: 当血糖(也称为血糖)水平高于正常水平，但还没有高到足以诊断为糖尿病. 糖化血红蛋白是5.7%到6%.4 percent (a way to estimate your 3-month average blood sugar reading), a fasting blood glucose level of 100 to 125 mg/dl, 或者OGTT(口服葡萄糖耐量试验)两小时血糖在140到199毫克/分升. 前驱糖尿病有时也被称为糖耐量受损或空腹血糖受损.

Whole grains: 谷物，比如全麦, brown rice and barley still have their fiber-rich outer shell, 叫做麸皮, and inner germ. 它提供维生素、矿物质和有益脂肪. 选择全谷物配菜, cereals, breads and more may lower the risk for heart disease, type 2 diabetes and cancer and improve digestion, too.