世界卫生日，我们打败糖尿病！
2016/4/7 护士学习笔记
来源：世界卫生组织公众号
中国约有1.1亿名糖尿病患者，约占中国成年人总数的1/10。若不尽快采取行动，减少不健康饮食和缺乏运动等生活方式中的危险因素，预计该数字将在2040年增至1.5亿人 ，给健康和社会经济带来严重影响。
▼
“打败糖尿病”今年世界卫生日的主题为“打败糖尿病”。借此契机，我们希望对糖尿病在中国日益增多的原因进行反思，同时探讨应采取何种行动遏制这种趋势。
1型糖尿病也称青少年糖尿病，病因不明，主要特点为患者体内无法生成足够的胰岛素，需要每天使用胰岛素治疗。2型糖尿病则是身体无法有效利用胰岛素造成的。2型糖尿病患者人数占患者总数的90%，超重和缺乏运动是主要病因。
施贺德博士世界卫生组织驻华代表“中国的2型糖尿病患病率在过去的二十多年中呈爆炸式增长。1980年，中国男性的患病率不到5%；现在，该比例已超过10%。主要原因在于不健康的生活方式，如，高糖和高脂的饮食结构和缺乏运动等。”
更为严重的是，中国近半数成年人处于糖尿病前期，约为5亿人。这不仅带来罹患2型糖尿病的风险，也带来罹患心血管病等其他疾病的风险。
不健康生活方式是威胁不健康饮食和缺乏运动导致中国超重和肥胖比例日趋上升，而后两者本身也是引发2型糖尿病的危险因素。中国现有1/3以上的成年人超重，7%的成年人肥胖。
不健康的生活方式使得中国儿童也面临罹患糖尿病的风险。11-17岁的青少年中，超过4/5的人缺乏运动，儿童超重率和肥胖率快速增长。1985年，中国儿童超重率和肥胖率为3%，到2010年，约1/10的女孩和1/5的男孩超重和肥胖。[i]
糖尿病等非传染性疾病是中国首要的健康威胁，每年导致的死亡人数占1.03亿死亡总数的80%，占中国总疾病负担的70%。糖尿病和糖尿病并发症每年导致近100万人死亡；令人担忧的是，其中近40%的死亡为过早死亡(在70岁以下人口中)。
“改变自己的生活方式并不难，长期来说可以降低罹患糖尿病和其他非传染性疾病的风险。遏制糖尿病继续增加的最佳方式，就是食用少糖、少盐和低脂食品，摄入更多水果和蔬菜，增加运动量。”
——施贺德博士世卫组织驻华代表
早期诊断、加强卫生服务是关键遗憾的是，糖尿病无法彻底治愈。但一旦确诊，可对糖尿病进行管理。例如若能早期诊断，可避免心脏病、肾衰竭和失明等后果。对于中国现有的1.1亿糖尿病人，中国需要提高早期发现、诊断和治疗的能力。
针对这一点，中国有许多工作要做：中国超过53%的糖尿病患者未得到诊断。2010年的调查显示，糖尿病患者的治疗率仅为25.8%。[ii]
“我们需要加强基层医疗和社区卫生服务，确保糖尿病患者能够得到诊断，使确诊的病人得到所需的治疗和照顾，这对提高糖尿病患者的生活质量至关重要，能够帮助他们过上长寿健康的生活。”
——施贺德博士世卫组织驻华代表
糖尿病更是经济负担糖尿病除了对患者及其家人朋友造成身心的伤害，也带来巨大的经济损失。中国每年投入近1734亿人民币(250亿美元)用于糖尿病管理；用于糖尿病的直接医疗支出占中国医疗支出的13%。[iii] 这些数据还未包括糖尿病相关疾病给患者家庭和公司带来的经济损失。
“从某种程度上说，中国糖尿病患病率的升高是中国经济快速发展的附带产物。例如，城市居民和经济发达地区居民的糖尿病发病率更高。但是，如不尽快采取行动遏制糖尿病和其他与生活方式相关的非传染病不断增加的势头，这些疾病造成的损失将使未来的卫生系统不堪重负，”
“因此，‘打败糖尿病’行动并不仅是健康问题，更是社会和经济问题，需要全社会参与的解决方案。每个人通过健康饮食和增加运动量，都可以降低患病风险。各级政府和全社会也有责任让人们更容易选择健康的生活方式。”
——施贺德博士世卫组织驻华代表参考文献：[i] Hong Xue, Yang Wu, Xiaoyu Wang, Youfa Wang. “Time Trends in Fast Food Consumption and Its Association with Obesity among Children in China,” PLOS ONE, Published March 12 2016.[ii] International Diabetes Federation, Diabetes Atlas – 7th Edition, 2015; Yu Xu et al. "Prevalence and Control of Diabetes in Chinese Adults," The Journal of the American Medical Association, 310.9 (2013): 948-959.[iii] Tsung O. Cheng, "Diabetes Epidemic in China and Its Economic Impact," International Journal of Cardiology, 149.1 (2011): 1-3.
Rate of diabetes in China “explosive” –Healthy diet and exercise key to turning the tide
Almost 10% of all adults in China – about 110 million people – currently live with diabetes. Without urgent action to reduce lifestyle risk factors like unhealthy diet and lack of physical activity, that number is expected to increase to 150 million by 2040 – with major health, social and economic consequences.
The theme of this year’s World Health Day is ‘Beat Diabetes’. This provides an opportunity to reflect on the causes of the increasing prevalence of the disease in China, as well as to discuss what can be done to stem the tide.
Type 1 diabetes (sometimes called juvenile diabetes) is characterized by deficient insulin production and requires daily administration of insulin. The cause of Type 1 diabetes is unknown. Type 2 diabetes results from the body’s ineffective use of insulin. Type 2 diabetes comprises 90% of people with diabetes around the world, and is largely the result of excess body weight and physical inactivity.
“Rates of Type 2 diabetes in China have exploded in the last couple of decades. In 1980, less than 5% of Chinese men had diabetes. Now, more than 10% do. This increase has been largely driven by unhealthy lifestyles – diets that are too high in sugar and fat, and people not getting enough physical activity,” said Dr Bernhard Schwartl?nder, WHO Representative in China.
Even more startling is the fact that almost half of all adults in China – close to 500 million people – have prediabetes. Not only does this pose a risk factor for developing Type 2 diabetes, but also for other conditions such as cardiovascular disease.
Unhealthy diets and lack of physical activity are driving increasing rates of overweight and obesity in China – which are themselves risk factors for developing Type 2 diabetes. More than one-third of adults in China are overweight, while 7% of adults are obese.
Unhealthy lifestyles are also putting China’s children at risk of developing diabetes: more than 4 in 5 adolescents 11-17 years do not get enough physical activity, and rates of overweight and obesity in children are increasing rapidly: from less than 3% in 1985 to around 1 in 10 in girls and 1 in 5 boys in 2010.[i]
Noncommunicable diseases (NCDs), including diabetes, are China's number one health threat, contributing more than 80% of the country's 103 million annual deaths, and nearly 70% of its total disease burden. Diabetes and complications from diabetes contribute to almost 1 million deaths in China each year. Alarmingly, nearly 40% of these deaths are premature (that is, in people below the age of 70).
“Making some simple lifestyle changes can go a long way towards reducing the risk getting of diabetes and other NCDs. Consuming less sugar, salt and fat, eating more fruits and vegetables, and getting more physical activity are key to helping reverse the tide,” said Dr Schwartl?nder.
Diabetes is unfortunately an incurable disease. But once diagnosed the disease can be managed – especially if detected early – and consequences like heart disease, kidney failure to blindness can be avoided. For the 110 million people in China already living with the disease, there is a need to strengthen early detection, diagnosis and treatment.
There is much work to be done in China in this regard: more than half (53%) of people with diabetes in China may be undiagnosed, and according to a survey in 2010 only one-quarter (25.8%) of all people with diabetes were receiving treatment for their condition.[ii]
“Building stronger primary and community health care services – so that those who have diabetes get diagnosed, and those who are diagnosed get the treatment and care that they need – is absolutely essential to improving the lives of people with diabetes and helping them live long and healthy lives,” said Dr Schwartl?nder.
In addition to the physical and emotional toll diabetes can take on people with diabetes and their families and friends, there is also a significant economic cost: China spends upwards of RMB 173.4 billion (US $25 billion) a year on the management of diabetes, and 13% of China's medical expenditures are directly caused by diabetes.[iii] These numbers do not include the economic losses that families and companies suffer from due to diabetes linked illnesses.
“The rise of diabetes in China is to some extent a side effect of China’s rapid economic development. We know, for instance, that the disease’s prevalence is higher among urban residents and people living in economically developed regions. But without action to stem the tide of increasing rates of diabetes and other lifestyle-related NCDs, the cost of these diseases will overwhelm the health system in the future,” Dr Schwartl?nder said.
“Beating Diabetes is therefore much more than just a health issue, but rather a social and economic issue which requires a whole-of-society solution. Individually, all of us can do more to reduce our own risk – by eating healthily, and getting more exercise. Governments at all levels and the broader community also have a role to play – to make healthy choices easier for everyone,” Dr Schwartl?nder concluded.
References:[i] Hong Xue, Yang Wu, Xiaoyu Wang, Youfa Wang. “Time Trends in Fast Food Consumption and Its Association with Obesity among Children in China,” PLOS ONE, Published March 12 2016.[ii] International Diabetes Federation, Diabetes Atlas – 7th Edition, 2015; Yu Xu et al. "Prevalence and Control of Diabetes in Chinese Adults," The Journal of the American Medical Association, 310.9 (2013): 948-959.[iii] Tsung O. Cheng, "Diabetes Epidemic in China and Its Economic Impact," International Journal of Cardiology, 149.1 (2011): 1-3.
相关阅读：
【人手一份】2016年护考资料大全，你值得收藏
【人手一份】心电图学习大全，不信你还不会，收藏之
人手一份|心肺复苏各种教学、演示大全，医务人员收藏必备
实习护生人手一份——实习秘籍
护士人手一份——50项护理操作视频(修订版)
护考万题库，请戳【阅读原文】
↓↓↓
http://www.duyihua.cn
返回 护士学习笔记 返回首页 返回百拇医药