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糖尿病与感染，你应该知道的！ 检索：潘红平 翻译：潘红平、陈志锦 编写：潘红平 审核：高珊、陈志锦 随着人们生活水平的提高，生活方式的改变以及人口的老龄化日益突出，糖尿病已成为一种常见病、多发病，给社会和经济带来了沉重的负担，并已成为严重威胁人类健康的世界性公共卫生问题。研究表明，高血糖是发生感染的独立危险因素，糖尿病患者是发生医院感染的高危人群。那么，糖尿病与感染，我们还有多少没有了解呢？请看美国感染控制与流行病学专业协会带给大家的最新警示。
1什么是糖尿病？ 糖尿病是一种慢性病，其患者的血糖水平高于正常值。胰岛素是一种帮助机体葡萄糖转化的激素，而糖尿病患者要么是胰岛素分泌不足，要么是胰岛素不能正常发挥作用。这会使血糖水平飙升，导致严重的并发症，例如失明、心脏病、肾脏衰竭以及下肢截肢等。 大多数的糖尿病患者主要分为以下两种类型： 1型糖尿病 1型糖尿病患者的机体不能产生胰岛素。食物中的糖和淀粉需要机体分解成名为葡萄糖的单糖来提供能量，而胰岛素正是机体细胞从血液中摄取葡萄糖过程中所需要的一种激素。 2型糖尿病 2型糖尿病是最常见的糖尿病类型。如果患者是这一类型，其机体存在胰岛素作用障碍，被称为胰岛素抵抗。在发病的初期，胰腺能够分泌额外的胰岛素来补充，但一段时间后，胰腺无法保持超负荷状态，不能分泌足够的胰岛素来维持机体的血糖处在正常水平。 2为什么糖尿病患者更容易发生感染？ 高血糖会降低人体免疫功能。长期糖尿病患者可能存在外周神经病变和肢体末端血流减少，致使感染风险的增加。血液以及组织内的高糖水平也会促进细菌的生长，并加速感染的发生。
3糖尿病患者最常见的感染类型有哪些？ 耳、鼻、喉感染：鼻腔和咽喉真菌感染几乎可以认为是糖尿病患者的特异性感染。症状包括剧烈的耳痛以及有耳分泌物。 尿路感染：糖尿病患者血糖控制不佳是其发生尿路感染的最主要原因。导致尿路感染常见的病原菌有：大肠埃希菌、克雷伯菌、肠球菌以及念珠菌。较常见的尿路感染为肾炎和膀胱炎。 皮肤及软组织感染：糖尿病患者和容易发生腿部感染和创伤（被称为糖尿病足）。反复的外伤以及劣质的鞋袜可能导致皮肤软组织感染的发生。如果这些感染没有进行及时且恰当的治疗，将有可能导致截肢。 4糖尿病患者如何预防感染？ 1.确保血糖水平控制良好：可以通过规律运动，健康饮食，遵从医务人员的建议进行常规血糖监测来实现。 2.遵从医嘱按时服药。 3.保持良好的个人卫生习惯。勤洗手，特别是在如厕、打喷嚏、擤鼻涕或者咳嗽之后，以及进食前，探视病人前后，或发现你手脏等时候，都需要洗手。 4.切勿与别人共用胰岛素注射笔。胰岛素笔应为一人一管。在医务人员使用胰岛素笔为您进行注射之前，应询问您是否为此笔的第一位使用患者。 5.每年进行流感疫苗接种，并坚持接种最新疫苗。 6.穿质量好、舒适且包裹性良好的鞋袜，每日更换干净的袜子。糖尿病患者还应每天检查足部。 7.当受伤或者生病时，应及早就医。
阅读完以上通俗易懂的糖尿病相关知识后，可以看出，控制血糖在预防感染方面的重要作用。大家是否发现了医院感染控制措施的影子呢？如手卫生的执行、胰岛素笔的一人一用。将糖尿病感染防控措施融入到健康教育中，对患者病情的控制以及预后将会产生积极的影响。 英文原文如下： Diabetes, infections, and you 6/27/2016 Access a printer-friendly copy of this alert What is diabetes? Diabetes is a chronic disease in which blood glucose (a type of sugar) levels are above normal levels. In people who have diabetes, the pancreas either doesn’t make enough insulin (a hormone that helps glucose get the cells of our bodies), or it doesn’t use insulin as well as it should. This can cause sugar to build up in the blood and lead to serious health complications like blindness, heart disease, kidney failure, and lower-extremity amputations. Most cases of diabetes fall into two broad categories: Type 1 diabetes In type 1 diabetes, the body does not produce insulin. The body breaks down the sugars and starches you eat into a simple sugar called glucose, which it uses for energy. Insulin is a hormone that the body needs to get glucose from the bloodstream into the cells of the body. Type 2 diabetes Type 2 diabetes is the most common form of diabetes. If you have type 2 diabetes, your body does not use insulin properly. This is called insulin resistance. At first, your pancreas makes extra insulin to make up for it. But, over time it isn't able to keep up and can't make enough insulin to keep your blood glucose at normal levels. Why are people with diabetes more prone to infections? High blood sugar levels can weaken a person’s immune system defenses. People who have had diabetes for a long time may have peripheral nerve damage and reduced blood flow to their extremities, which increases the chance for infection. The high sugar levels in your blood and tissues allow bacteria to grow and allow infections to develop more quickly. What are common infections for people with diabetes? The most common infections in people with diabetes include: ·Ear, nose, and throat infections: Fungal infections of the nose and throat are seen almost exclusively in patients with diabetes. Symptoms include severe ear pain and ear discharge. ·Urinary tract infections (UTIs): Uncontrolled diabetes is one of the major causes for UTIs. These UTIs are commonly caused by germs such as Escherichia coli, Klebsiella, Enterococcus, and Candida. Kidney infections and inflammation of the bladder are also common. ·Skin and soft tissue infections: People with diabetes are at risk for infections and wounds in the leg (also called diabetic foot). Repeated trauma and poor footwear can lead to these infections. If these infections aren’t treated promptly and properly, it can result in the need to amputate. How can people with diabetes prevent infection? 1.Make sure your blood sugar levels are well controlled. This can be achieved by exercising regularly, making healthy food choices, and following your healthcare provider’s recommendations for routine blood glucose testing. 2.Take medicines exactly as prescribed by your healthcare provider. 3.Maintain good personal hygiene. Wash your hands frequently, especially after using the bathroom; after sneezing, blowing your nose, or coughing; before eating; when visiting someone who is sick; or whenever your hands are dirty. 4.Never share your insulin pen. These are meant for only one person. Before your healthcare provider uses an insulin pen on you, ask if you are the first patient to use that particular pen. 5.Get your flu vaccine each year and stay up to date on all vaccinations. 6.Wear good, soft, and covered footwear. Wear clean socks daily. People who have diabetes should examine their feet on a daily basis. 7.Seek early medical care if you are injured or ill. |
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