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USNEWS：高血糖的6大并发症！
名医：Dr. Steven Alberts, MD（Mayo Clinic）
2018年11月30日
马萨诸塞州总医院（Massachusetts General Hospital, Boston, Mass.）
2018年12月3日
By K. Aleisha Fetters（作者）
不管你是否患有糖尿病、糖尿病前期，或者只是想降低你将来诊断的风险，你可能知道保持血糖水平是很重要的。
为什么控制血糖水平很重要？简单地说，血液会影响和影响你身体的每一件事，肥胖医学协会的当选总统Craig Primack博士说。
在这里，专家们分享了六种意想不到的方式：高血糖水平会对你的健康产生不利影响。
心血管疾病。考虑这种情况：两个人进入急诊室抱怨胸痛。过去曾有一次心脏病发作。另一个则患有糖尿病。谁更容易患心脏病？Primack说，一个患有糖尿病的人解释说，这种情况在医学院通常被用来证明糖尿病是如何起到“冠状动脉疾病等效”的作用。“如果你有糖尿病，你基本上已经有冠状动脉疾病，即使它还没有被诊断出来，”他说。
尽管专家们认为饮食胆固醇是动脉阻塞斑块的主要罪魁祸首，但目前的研究表明，血液中过量的糖可能起到更大的作用，Primack说。高血糖水平增加了自由基的产生，高活性分子导致过早的细胞死亡，并降低一氧化氮的可用性，一氧化氮是一种需要血管放松的化合物，尽管斑块形成，血液可以自由流动。
据国际糖尿病基金会报道，心脏病是糖尿病患者死亡的首要原因。
Primack说，高血糖水平和降低心脏血液流动的相同因素减少了性器官的血液循环。
据波士顿哈佛医学院附属约瑟林糖尿病中心报道，10岁以上糖尿病患者中有一半以上患有勃起功能障碍，血糖水平较低的人更容易发生性副作用。血糖控制的糖。据克利夫兰诊所报道，尽管他们的研究较少，但长期处于高血糖水平的女性也会出现性问题。如阴道干燥，低水平的性兴趣和难以达到性高潮的副作用可能发生。
Primack说：“近年来，我们已经开始称阿尔茨海默氏症为大脑的糖尿病。”其他人称之为3型糖尿病。无论哪种方式，无论你的糖尿病诊断，高血糖和认知衰退之间的联系都很强。例如，发表在糖尿病杂志上的2018项研究，跟踪了5189人在10年的过程中，发现血糖水平最高的人认知衰退的速度最快。
研究人员还不知道糖-脑连接的充分解释，但减少的血流很可能起作用，Primack说。
大多数人都听说过糖尿病神经病变，其中长期高血糖水平损害全身神经细胞，导致针、针感觉甚至手足麻木。但这是一个鲜为人知的事实：这种神经损伤也会恶化身体的关节，Jeff E. Sellman博士解释说，他是坦帕佛罗里达骨科研究所的家庭和运动医学医师。称为Charcot关节或糖尿病关节病，它可以导致关节中的不稳定性和变形，通常在脚。
同时，血液中过量的葡萄糖可粘附在关节表面，降解胶原，减少关节活动性。
肾脏疾病通过损害肾脏的血管，长期高血糖水平也可以减少肾功能，并有助于肾脏疾病。患糖尿病的时间越长，糖尿病失控的时间越长，患肾病的风险就越大。根据疾病控制和预防中心，三分之一的糖尿病患者患有慢性肾脏疾病。
肾脏有助于平衡液体水平，并从体内排出废物，因此对整体健康至关重要。如果你患有2型糖尿病或患有1型糖尿病超过五年，美国国家糖尿病和消化和肾脏疾病研究所建议你每年检查一下你的肾功能。
专家们曾认为，糖尿病的日常消沉是增加了1型糖尿病和2型糖尿病患者抑郁的风险，但新的研究表明，血糖水平可能比血糖读数和胰岛素指数大得多。林枪。
例如，发表在《神经科学杂志》上的2015项研究表明，对于1型糖尿病患者，高血糖水平会增加大脑的神经传递水平。
大多数人听说过糖尿病神经病，其中长期的高血糖水平损害了整个身体的神经细胞，导致针-针的感觉，甚至手、脚、手臂和腿的麻木。但是这里有一个不太为人所知的事实：这种神经损伤也可能恶化身体的关节，杰夫·E·塞尔曼博士解释说，他是坦帕市佛罗里达矫形研究所的一名家庭和运动医学医生。它被称为Charcot关节或糖尿病性关节病，可引起关节不稳定和变形，通常在足部。
同时，血液中过量的葡萄糖可以粘附在关节表面，降解胶原并降低关节活动性。
肾脏疾病。通过损害肾脏中的血管，慢性高血糖水平也可能降低肾功能并导致肾脏疾病。一个人患糖尿病的时间越长，糖尿病失控的时间越长，导致肾脏疾病的风险就越大。根据疾病控制和预防中心的数据，三分之一的糖尿病患者患有慢性肾病。
肾脏有助于平衡体液水平和清除体内废物，因此对于整体健康至关重要。如果你患有2型糖尿病或者已经患有1型糖尿病超过5年，国家糖尿病和消化与肾脏疾病研究所建议每年检查你的肾功能。
专家们过去常常认为，糖尿病治疗的日常低迷增加了1型和2型糖尿病患者患抑郁症的风险，但新出现的研究表明，血糖水平可能远比血糖读数和保险要低得多。林枪。
例如，发表在《神经科学杂志》上的2015年研究显示，对于1型糖尿病患者，高血糖水平会增加大脑中与抑郁症相关的神经递质的水平。研究还发现，高糖水平会改变大脑中控制情绪的区域之间的联系，从而可能导致心理健康问题。
原文：
WHETHER YOU HAVE diabetes, prediabetes or just want to cut your risk of a future diagnosis, you probably know that it’s important to keep your blood sugar levels in check.
Why is it important to control your blood sugar levels? Put simply, blood reaches and influences everything in your body, says Dr. Craig Primack, president-elect of the Obesity Medicine Association.
Here, experts share six unexpected ways high blood sugar levels can adversely impact your health.
Cardiovascular disease. Consider this scenario: Two people enter the emergency room complaining of chest pain. One has suffered a heart attack in the past. The other has diabetes.
Who is more likely to be having a heart attack? The one with diabetes, Primack says, explaining that this situation is commonly used in medical schools to demonstrate how diabetes acts as a “coronary artery disease equivalent.” “If you have diabetes, you basically already have coronary artery disease, even if it hasn’t been diagnosed,” he says.
While experts used to believe that dietary cholesterol was the main culprit behind artery-clogging plaque, current research suggests excess levels of sugar in the blood likely play a larger role, Primack says. High blood sugar levels increase the production of free radicals, highly reactive molecules that cause premature cell death and reduce the availability of nitric oxide, a compound that’s needed for blood vessels to relax and allow blood to flow freely despite plaque buildup.
Heart disease is the leading cause of death among people with diabetes, according to the International Diabetes Foundation.
Sexual dysfunction. With high blood sugar levels, the same factors that decrease blood flow to the heart reduce blood circulation to the sexual organs, Primack says.
According to the Joslin Diabetes Center, an affiliate of Harvard Medical School in Boston, more than one-half of men who have diabetes for 10 years also suffer from erectile dysfunction, and those with poorly controlled blood sugar levels are more likely to have sexual side effects compared with those who have their blood sugar under control. While they have been less studied, sexual issues are also common in women with chronically high blood sugar levels, according to the Cleveland Clinic. Side effects such as vaginal dryness, low levels of sexual interest and difficulty reaching orgasm can occur.
Cognitive decline. “In recent years, we have begun to call Alzheimer’s disease diabetes of the brain,” Primack says. Others have called it Type 3 diabetes. Either way, the link between high blood sugar and cognitive declineis strong, no matter your diabetes diagnosis. For example, a 2018 study published in the journal Diabetologia, which tracked 5,189 people over the course of 10 years, showed that those with the highest blood sugar level had the fastest rate of cognitive decline.
Researchers don’t yet know the full explanation between the sugar-brain connection, but reduced blood flow is likely to play a role, Primack says.
Bone and joint problems. Most people have heard of diabetic neuropathy, in which chronically high blood sugar levels damage nerve cells throughout the body, leading to a pins-and-needles sensation and even numbness in the hands, feet, arms and legs. But here’s a lesser-known fact: This nerve damage can also deteriorate the body’s joints, explains Dr. Jeff E. Sellman, a family and sports medicine physician with the Florida Orthopaedic Institute in Tampa. Called Charcot joint or diabetic arthropathy, it can cause instability and deformations in the joints, commonly in the feet.
Meanwhile, excess levels of glucose in the blood can adhere to joint surfaces, degrade collagen and reduce joint mobility.
Kidney disease. By damaging blood vessels in the kidneys, chronically high blood sugar levels can also reduce kidney function and contribute to renal disease. The longer someone has diabetes, and the longer that diabetes goes uncontrolled, the greater the risk of resulting kidney disease. According to the Centers for Disease Control and Prevention, one-third of people with diabetes have chronic kidney disease.
The kidneys help balance fluid levels and remove waste from the body, and thus are vital to overall health. If you have Type 2 diabetes or have had Type 1 diabetes for more than five years, the National Institute of Diabetes and Digestive and Kidney Diseases recommends having your kidney function checked every year.
Depression. Experts used to think it was the day-to-day doldrums of managing diabetes that increased the risk of depression in people with Type 1 and Type 2 diabetes, but emerging research suggests that blood sugar levels may be a far greater depressant than taking blood sugar readings and insulin shots.
For example, 2015 research published in The Journal of Neuroscience shows that, for those with Type 1 diabetes, high blood sugar levels increase the brain’s levels of a neurotransmitter associated with depression. The study also found that high sugar levels alter connections between regions of the brain that control emotion, potentially contributing to mental health issues.
