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【双语课堂】糖尿病并发症:你有哪一种?
2010-09-01 17:51 丁香园 苹果嘿嘿  发布范围:公开

Diabetes Complications: What's Your Risk?
Why are people with diabetes at high risk of nerve pain, heart disease, and blindness?
By Jeanie Lerche Davis
http://diabetes.webmd.com/diabetes-complications-9/risk-of-complications
糖尿病并发症:你有哪一种?
为什么糖尿病患者总是存在高风险的神经痛、心脏疾病、失明的并发症?

WebMD Feature Reviewed by Brunilda Nazario, MD Heart attack, stroke, blindness, amputation, kidney failure. When doctors describe these diabetes complications, it may sound melodramatic -- like an overblown worst-case scenario. The truth is, these things can happen when blood sugar, blood pressure, and cholesterol are out of control.
在一家医疗网站上Brunilda Nazario博士将其总结为心脏病、中风、失明、截肢、肾衰竭。医生们描述这些并发症的时候,听起来是有些伤感的——像是被夸大了的最坏的情况。事实是,当血糖、血压和胆固醇失去控制时,这些都是有可能发生的。

"A lot of people don't really think it will happen to them," says David C. Ziemer, MD, director of the Diabetes Clinic at Grady Hospital in Atlanta. "For a lot of folks, the wake-up comes when they actually have a complication ... a bad infection in the foot. That's a nasty wake-up call."
“很多人认为这些事情不会真的发生在他们身上,” David C. Ziemer博士说。他是亚特兰大Grady医院糖尿病诊所的指导医生,他说:“对很多人而言,当他们确实得了一种并发症的时候,例如一只感染的糖尿病足,就该清醒了。这是让人不那么愉快的警钟。”

If you have uncontrolled diabetes, a serious and deep-seated foot infection can mean loss of a toe, foot, or leg -- amputation -- to save your life. Seriously.
如果你的血糖失去控制,一次严重的深度的脚步感染就可能意味着失去一个脚趾头、一只脚甚至一条腿——切断它们,是为了救你的命。这是个严肃的问题。

How is this possible? Over time, high blood sugar slowly injures the blood vessels, nerves, and organs in your body. The higher your blood sugar is -- and the longer it stays high -- the worse the damage is. Smoking and alcohol ratchet up the damage several more notches.
怎么会这样呢?随着时间的发展,高血糖会慢慢地损伤血管,神经和身体里的器官。血糖越高,并且高血糖维持的时间越长的时候,损伤就越严重。吸烟和喝酒加深了这种损伤。

"Damage is slow and occurs over a period of years -- but it probably begins when blood sugar is at mildly elevated levels," says Ronald Goldberg, MD, associate director of the Diabetes Research Institute at the University of Miami Medical Center. "You may not be diagnosed with diabetes, but the damage has already begun."
“损伤时缓慢进行的,有时经过几年的时间才发生——但是当血糖在一个比较轻度水平提高的时候,它可能就已经开始损伤你的身体了。” 迈阿密医学中心大学糖尿病研究所的副指导员Ronald Goldberg博士说,“你可能还没有被诊断出糖尿病,但是损伤确实已经开始发生了。”

The damage from diabetes shows up a bit differently in everyone -- whether it attacks the nerves, eyes, or kidneys, Goldberg tells WebMD. "Genetics probably influence which complications you are more susceptible to."
糖尿病患者的损伤在每一个人的身上有那么一点不同,它可能攻击你的神经、眼睛或者肾脏。Goldberg对医学在线说:“基因可能会影响你最容易患上哪种并发症。”

The problem is, "many people have diabetes a lot longer than they realize," says Ziemer. "Most have diabetes an average of five to seven years before they're diagnosed."
问题是“很多人在患上糖尿病很久之之后才意识到自己得了糖尿病。” Ziemer说,“大部分人在诊断出患有糖尿病之前,已经有了平均5-7年的病史。”

Diabetes Complications: The Risks You Face
As blood vessels, nerves, and organs become damaged, your risk of diabetes complications increases.
糖尿病并发症:你面临的风险
随着血管、神经和器官被损伤,糖尿病并发症的风险也在升高。

These are the most serious:Heart disease, heart attack, heart failure, and stroke risks are doubled. Heart disease and stroke cause at least 65% of deaths from diabetes.
Major eye complications (diabetic retinopathy) are linked to blood vessel problems in the eyes. Diabetes is a leading cause of preventable blindness; cataracts and glaucoma are also common.
最严重的并发症有:心脏病、心脏病发作、心力衰竭和中风的风险增加了一倍。心脏病和中风至少引起糖尿病患者中65%的死亡率。大部分的眼部并发症(糖尿病性视网膜病)涉及到眼压的问题。糖尿病是可预防的失明的主要原因,糖尿病引起的白内障和青光眼也很常见。

Reduced blood flow to nerves and high blood sugar results in nerve pain, burning, numbness (peripheral neuropathy).
Serious leg and foot infections, even gangrene and amputation, are due to poor blood circulation, lack of oxygen and nutrients to tissue, and nerve damage.
流向神经的血液减少,高血糖导致神经疼痛,灼热,麻木(周围神经病)。
严重的腿部和脚步感染,甚至坏疽和截肢,这都是由于血液循环不良,肌肉缺少氧气和营养,神经损伤导致的。

Kidney damage (diabetic nephropathy) is a common risk for people with diabetes.
The complications of diabetes are indeed serious -- but they are not inevitable, Ziemer tells WebMD. "Keeping blood sugar under control is the single the most important factor in preventing them. But people have a hard time grasping just how critical that is," he says. "It's hard to get them to tune into it."
肾脏损伤(糖尿病性肾病变)是糖尿病患者最常经历的风险。糖尿病并发症确实是很严重的,但它们并非不可避免,Ziemer对医学在线说。“将血糖保持的合理范围内是防止并发症的最直接重要的因素。但是,人们很难把握到这有多重要,”他说,“很难让人们听进去。”

Preventing Diabetes Complications With Medication
Getting blood sugar under control isn't always difficult. Sometimes all you need are lifestyle changes -- eating right, getting regular exercise, losing weight -- to get it into a safe range. If you're a smoker, there's no question -- you've got to quit.
药物治疗预防糖尿病并发症
控制血糖并不总是很难。有时,你需要的只是生活方式的改变——吃正确的食物,有规律的运动,减轻体重,使之在安全的范围之内。如果你吸烟,那也没问题,戒烟就可以了。

Also, finding ways to ease the stress in your life helps control blood sugar, as does treatment for depression. Both stress and depression increase the level of cortisol, a hormone that affects blood sugar. "Cortisol makes the diabetes worse," Ziemer tells WebMD. "There is evidence that treating depression may help blood sugar control." He is heading a study investigating that link.
同时,找到减轻压力的方法也有助于控制血糖,用同样的方法处理抑郁也一样。压力和抑郁都能升高氢化可的松的水平,氢化可的松是一种影响血糖的荷尔蒙。“氢化可的松使糖尿病变得更糟,”
Ziemer告诉医学在线,“有证据表明治疗抑郁有助于控制血糖。”他正领导一项研究检测二者之间的联系。
For some people, taking just one diabetes medication helps tremendously. Complex new drugs like Byetta, Januvia, and Symlin work from different angles to attack high blood sugar. "All the new drugs hold a lot of promise," says Ziemer, who is also a professor of endocrinology at Emory University School of Medicine in Atlanta.
对有些人而言,仅服用一种治疗糖尿病的药物后果是可怕的。复杂的新型药物,例如Byetta,Januvia和 Symlin从不同的方面起效治疗更高水平的血糖。“所有这些新的药物都有很多疗效,”
Ziemer说。Ziemer同时也是亚特兰大Emory大学医学院的内分泌学的教授。
If you need to take insulin, you'll find the injections aren't that bad. "The new versions of insulin are far less cumbersome," Ziemer explains. You don't need to lay out a lot of needles and vials on the table. The insulin can be discreetly injected via a little pen -- much like a cartridge writing pen. Insulin mouth sprays and insulin patches are being developed.
如果你需要使用胰岛素,那么就要确定注射不是那么坏的方法。“胰岛素的新剂型远没有那么繁琐,” Ziemer解释说。你不需要使用许多针管和小玻璃瓶,胰岛素可以一个小钢笔——或许更像一个书写墨盒的东西,直接注射入身体。胰岛素口腔喷剂和贴剂正在开发中。

Fewer Diabetes Complications = Less Pain
By reining in blood sugar, you slow down the damage to the body's nerves and blood vessels. You can even halt damage altogether. The benefits show up in many ways.
更好的糖尿病并发症=更少的疼痛
通过控制血糖,减慢了对神经和血管的损害。甚至可以完全消除停止所有的损害。好处体现在很多方面。
You can ease the pain or numbness you feel in hands, arms, feet, and legs. "When you prevent more damage to nerves, you keep pain from getting worse," Ziemer explains. "We don't have any medications to repair nerve damage. Mostly, we're protecting what's left."
可以减轻疼痛或者手部、胳膊、脚和腿部的麻木。“当阻止了对神经的大部分损害之后,就阻止了疼痛的进一步恶化。” Ziemer说,“没有任何一种药物能够修复损伤的神经。大部分情况下,我们只是保护剩余的神经。”

Gum disease and tooth loss can be halted when blood sugar is controlled, adds Ziemer. "In fact, when you get gum infection under control, you help keep blood sugar under control. Infection in the gums increases inflammation in the body, which makes controlling diabetes harder."
Ziemer补充说,血糖控制的视乎,牙龈疾病和掉牙齿的情况也能停止。“事实上,当牙龈感染得到控制的时候,有助于血糖的控制。牙龈感染增加了机体的炎症,而炎症会使糖尿病的控制更加困难,”

Don't put dental visits on the back burner, says Ziemer. "A lot of folks end up losing lots of teeth. Nobody likes going to the dentist, me included. But seeing a dentist is very important."
不要推迟你的牙齿诊断,Ziemer说。“许多人最终失去了大量的牙齿。没有人喜欢看牙医,包括我在内。可是看牙医是非常重要的。”

Blood sugar isn't the only issue, diabetes experts agree. If there are cholesterol and blood pressure problems -- as there typically are -- they need aggressive treatment with medication. Both these conditions affect the health of large and small blood vessels, and greatly aggravate the damage done by diabetes.
血糖不是唯一的问题,糖尿病专家建议说。如果没有胆固醇和血压的问题——事实上通常都有——他们需要积极地药物治疗。这两个条件影响着大血管和小血管的健康,并且极大地恶化了糖尿病引起的损伤。

Cholesterol-lowering drugs like statins are a mainstay in diabetes treatment. Blood pressure drugs like ACE inhibitors can also improve blood flow throughout the body, including legs and kidneys. "These drugs protect kidneys from damage and they protect the heart muscle, which helps prevent heart failure," Ziemer tells WebMD.
降胆固醇药物例如statins是治疗糖尿病药物的主要药物。血压药物例如血管张力素转化酶抑制剂,也能促进血流流通身体,包括腿和肾脏。“这些药物保护肾脏不受损害,保护心肌以防止心力衰竭。” Ziemer说。

With these diabetes complications, there's a lot at stake. Can you really prevent the worst-case scenario? "Absolutely," Goldberg tells WebMD. "If you do all these things, you can substantially reduce risk of heart attack, stroke, and the blood vessel damage that leads to blindness, amputations, and kidney damage. But you must start doing them as early as possible. And you have to keep things under control ... strict control."
患有糖尿病并发症存在许多危险。你真的能阻止最糟糕的情况发生吗?“当然可以,”Goldberg告诉医学在线,“如果做了所有的事情,你当然能降低心脏病发作,中风和血管损伤这些可能导致失明、截肢和肾脏损害的危险。到那时你必须开始尽可能早地行动。并且,你必须使事情在控制范围之内,严格地控制在范围之内。”

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