胰岛素:从20世纪70年代到本世纪,糖尿病治疗的重大转变

IF 0.4 Q4 ENDOCRINOLOGY & METABOLISM British Journal of Diabetes Pub Date : 2022-12-22 DOI:10.15277/bjd.2022.355
K. Shaw
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引用次数: 1

摘要

20世纪的最后30年见证了糖尿病治疗的惊人进展。在20世纪70年代,糖尿病提供几乎完全以医院为基础,但到2000年,糖尿病人数的指数爆炸需要糖尿病服务的完全重组,大量转向初级保健,而医院糖尿病中心则侧重于更具体的专家和复杂的亚组。这段时间见证了糖尿病管理的根本性转变,从历史经验,严格的一致性,公开的说教和规定的性质,到一个更加以患者为中心和灵活的方法的指导原则。在这段时间里,我们目睹了胰岛素及其使用的巨大发展——新的胰岛素,新的输送装置——一旦良好的糖尿病控制的重要性被完全接受,合理的证据基础建立起来,对这种监测从间接的和通常不充分的尿液分析转变为越来越复杂的血糖测量,无论是即时的还是长期的。随着这些变革性的发展,对医疗保健专业人员和糖尿病患者的教育成为整合到糖尿病护理这一独特回报领域的首要任务。
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Insulin: a momentous transformation of diabetes care from the 1970s to the millennium
Introduction The last three decades of the 20th century witnessed a spectacular and remarkable progression in the delivery of diabetes care. In the 1970s diabetes provision was almost entirely hospital-based but by the millennium the exponential explosion of diabetes numbers necessitated a complete restructuring of diabetes services with a substantial switch to primary care, while hospital diabetes centres focused on more specific specialist and complicated subgroups. This period of time saw a radical transformation of diabetes management from an historical empirical, rigid conformity, overtly didactic and prescriptive in nature, to the guiding principle of a much more patient-centered and flexible approach. In this time, we witnessed dramatic developments with insulin and its usage – new insulins, new delivery devices – and once the importance of good diabetes control was fully accepted and the rational evidence base established, the monitoring of such metamorphosed from indirect and generally inadequate urinalysis to the increasingly sophisticated measurement of blood glucose, both immediate and long-term. With these transformative developments, education for healthcare professionals, and for people living with diabetes, became a prime priority to be integrated into the singularly rewarding domain of diabetes care.
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来源期刊
British Journal of Diabetes
British Journal of Diabetes ENDOCRINOLOGY & METABOLISM-
自引率
16.70%
发文量
15
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