糖尿病英语文献

西格尔等人。[ 17]最近描述的需求为基础的人力规划框架估计健康的劳动力队伍（即，技能组合和时间）所需的支持提供最佳的照顾，一个区域的人口。本质上，该框架包含三个相关的组成部分，彼此建立：（1）能力和技能的需求评估，（2）估计区域服务的要求，以及（3）政策的影响（参见图1）。本文报告的调查结果从最近的一项运动的实施模型，通过一个应用程序的糖尿病。这里的重点是与需求评估，采取区域一级。需求评估包括四个阶段：（1）描述的健康状况的人口，（2）估计的人口与定义的属性为选定的区域，（3）整理证据方面的最佳做法的照顾每一个确定的亚，和（4）翻译的最佳保健护理协议。说明健康状况的人口第一项活动是确定病人亚/病人的属性，确定需要一个独特的临床团队达到最佳的糖尿病的护理。这是通过一个阶段：•战略审查的文献，包括一个关键的评价临床实践指南（集团），以确定病人的属性可能相关的糖尿病管理。搜索进行使用数据库，文摘，和cinahl，和下面的搜索条件：糖尿病，妊娠糖尿病，健康状况，健康行为，病人顺应性，自我保健，自我效能，治疗结果，1型糖尿病，和2型糖尿病。搜索限于论文发表在英语语言后的一年1990，和一个提供摘要。•讨论与专家学术小组确定病人额外的属性。该小组由专家在糖尿病，糖尿病教育，社区护理学，营养学，足病，心脏病，职业疗法，和公共健康；所有的临床专业知识，管理糖尿病。•讨论跨学科小组的临床医生与糖尿病患者在城市阿德雷德（南澳大利亚）或区域中心的怀阿拉（南澳大利亚）。目的是查明额外的亚群，以及寻求确认或调整的关键病人的属性，确定通过前处理，用改进的名义组技术。基本上，临床医生对亚分离和不影响从面板。然后他们分享他们的意见在小组会议和讨论中提出的建议。结果迭代点共识，确定的方式投票。

Diabetes is a group characterized by high blood sugar and metabolic Hyperglycemia is due to defects in insulin secretion or action of biological damage, or both Longstanding diabetes high blood sugar, leading to a variety of organizations, particularly chronic damage to the eyes, kidneys, heart, blood vessels, nerves, and Cause of genetic factorsType 1 or type 2 diabetes are significant genetic Diabetes onset familial tendency, 1/4 to 1/2 patients have a family history of Clinically, there are at least 60 or more kinds of genetic syndromes may be associated with Type 1 diabetes has multiple DNA sites involved in the pathogenesis, which DQ polymorphism loci HLA antigen genes most In type 2 diabetes has found a variety of mutations in specific genes, such as the insulin gene, insulin receptor gene, glucokinase genes, mitochondrial envirnmental factorEating too much physical activity to reduce obesity leads to type 2 diabetes is the most important environmental factors that make individuals with susceptibility to type 2 diabetes genetic Type 1 diabetes patients with immune system abnormalities, after some viruses such as coxsackie virus, rubella virus, parotid gland virus infection leads to autoimmune reactions, destroy the insulin β Clinical Polydipsia, polyuria, polyphagia and weight lossThe typical "little" severe symptoms of high blood sugar, more common in type 1 When ketosis or ketoacidosis, "a little" more obvious Fatigue, weakness, obesityMore common in type 2 Type 2 diabetes often before the onset of obesity, if not timely diagnosis, weight will gradually an blood sugarIt is the Sole Criterion for the diagnosis of Obviously "a little" symptoms, as long as the abnormal blood glucose level can be diagnosed Asymptomatic diabetes diagnosis requires two abnormal blood glucose Suspects to be done to 75g glucose tolerance UrineOften Positive urine when blood glucose concentration exceeds the renal threshold for glucose (160 to 180 mg / dl) Renal glucose threshold increased blood sugar even reach a diagnosis of diabetes can be Therefore, urine is not measured as diagnostic KetonePositive urine ketone ketosis or Glycosylated hemoglobin (HbA1c)Is a non-enzymatic reaction of glucose and hemoglobin product of the reaction is not reversible, stable HbA1c levels reflect the average blood glucose level before taking the blood of two Analyzing the state of glycemic control is the most valuable Glycated serum proteinIt is a non-enzymatic reaction with glucose serum albumin product of the combination, before taking reflect the average blood glucose level of 1 to 3 Serum insulin and C-peptide levelsReflect reserve islet β Type 2 diabetes early or obese normal or elevated serum insulin, as the disease progresses, islet function gradually decline, decreased insulin LipidDiabetic dyslipidemia common in poorly controlled blood sugar Expressed as triglycerides, total cholesterol, elevated LDL cholesterol Reduce high-density lipoprotein cholesterol Immune IndexesIslet cell antibodies (ICA), insulin autoantibodies (IAA) and glutamic acid decarboxylase (GAD) antibodies are type 1 diabetes humoral immune abnormalities of three important indicators, which GAD antibody positive rate, long duration of 1 Great value diabetes In type 1 diabetes in first-degree relatives also have some positive rate, meaning there is prediction of type 1 Urinary albumin excretion, RIA or enzyme-linked methodCan be easily detected by urinary albumin excretion, early diabetic nephropathy urinary albumin increased diagnosisDiabetes diagnosis usually is not difficult, fasting blood glucose greater than or equal to 0 mmol / l, and / or two-hour postprandial blood glucose greater than or equal to 1 mmol / l can be After the diagnosis of diabetes to be typing:1 diabetesAge of onset of light, mostly <30 years, sudden onset, polydipsia and polyuria more food weight loss symptoms, high blood sugar levels, many patients with ketoacidosis as the first symptom, serum insulin and C-peptide levels low, ICA, IAA or GAD antibody Oral medication alone is invalid, required insulin 2 diabetesCommon in the elderly, a high incidence of obesity, often associated with hypertension, dyslipidemia, atherosclerosis and other Insidious onset, early without any symptoms, or only mild weakness, thirst, blood sugar tolerance test were not obvious to be done to confirm the Serum insulin levels normal or increased early and late