糖尿病治疗新策略

Although available drugs all improve blood-sugar levels, there is a lack of data to show whether they actually prevent or delay development of diabetes' long-term consequences.
尽管现有的药物都能改善血糖水平，但仍然缺乏有关它们是否真能阻止或延迟糖尿病的慢性并发症进一步加重的数据。

'The goal for treatment and the choice of individual drug must be personalized depending on the patient,' says Vivian Fonseca, the ADA's president for science and medicine and chief of endocrinology at Tulane University Health Sciences Center, in New Orleans.
ADA科学与医学事务主席、新奥尔良杜兰大学医学中心(Tulan University Health Sciences Center)内分泌学主任薇薇安•冯塞卡(Vivian Fonseca)认为，必须根据病人的情况制定专门的治疗目标和选择药物。

For most patients newly diagnosed with Type 2 diabetes, the first line of therapy is to improve diet and exercise habits to reduce blood-sugar levels. Usually metformin, a basic diabetes medication, is also prescribed. But patients with only mildly elevated blood-sugar levels may try to improve their health habits for up to six months to see if they can control the disease before beginning medication.
对于大多数新近被诊断患有II型糖尿病的患者，首先展开的系列疗法就是改善饮食和锻炼习惯以降低血糖水平，同时医生常常还会给他们开一种名为二甲双胍的治疗糖尿病的基本药物。不过，如果患者的血糖水平只是温和上升，他们可能要先试着改善自己的生活习惯六个月时间，以看看是否能在用药之前控制住糖尿病。

Blood sugar is typically defined as being under control for diabetic patients when it is below 7%, using a measure known as hemoglobin A1c, or HbA1c, according to the ADA. Under the new guidelines, that level is still desirable. But younger, newly diagnosed and well-motivated patients with a long life expectancy may want to aim for even lower levels, closer to 6%, according to the recommendations. Such aggressive therapy is expected to better keep the disease from progressing.
ADA称，糖化血红蛋白(HbA1c)水平低于7%的糖尿病患者通常会被认定血糖受到控制。新发布的指引也认为这一水平比较理想。但是，指引中还提到，年纪较轻、新近被诊断患病、强烈希望自身长寿的患者可能要把血糖控制在接近6%的更低水平。这一比较激进的治疗方案可能会更好地防止糖尿病加重。

For older patients vulnerable to severe hypoglycemia or who may already have advanced cardiovascular disease, less stringent targets of up to 8% or even a little higher would be sufficient, the guidelines say. This also could reduce the burden of side effects from medications.
新指引称，对于易患严重低血糖症的老年患者或是可能已经患有心血管疾病的患者，目标可以放松一些，8%甚至是略高一些的血糖水平就足够了。这可能会减轻药物副作用带来的负担。