两点ogtt，轻松诊断igtPPT课件

两点OGTT，轻松诊断IGT北京大学第一医院高妍封面替换成DA封面目录 指南推荐—— OGTT是诊断冠心病患者合并高血糖的必要手段 超出想象—— 冠心病患者不行OGTT检查漏诊大量糖代谢异常人群 临床现状—— 中国心内科OGTT推行现状堪忧 付诸行动—— 积极筛查两点OGTT，改善心血管预后 目录 指南推荐—— OGTT是诊断冠心病患者合并高血糖的必要手段 超出想象—— 冠心病患者不行OGTT检查漏诊大量糖代谢异常人群 临床现状—— 中国心内科OGTT推行现状堪忧 付诸行动—— 积极筛查两点OGTT，改善心血管预后 糖代谢异常的诊断包括空腹血糖和OGTT2h血糖两个 标准 excel标准偏差excel标准偏差函数exl标准差函数国标检验抽样标准表免费下载红头文件格式标准下载 糖尿病I-IFG(单纯空腹血糖异常)IFG+IGT空腹血糖(mmol/l)OGTT2hr血糖(mmol/l)*ShawJE,etal.Diabetologia42:1050,1999ResnickHE,etal.DiabetesCare23:176,2000Barrett-ConnerE,etal.DiabetesCare21:1236,1998GenuthS,etal.DiabetesCare.2003;26(11):3160-7.5.6I-IGT(单纯糖耐量异常)糖尿病*OGTT是IGT的唯一诊断方式30min0min60min120min90minSTART空腹取血后，5min内饮入含有75g葡萄糖的糖水180min180min，一般较少检测WorldHealthOrganization:DiabetesMellitus:ReportofaWHOStudyGroup.Geneva,WorldHealthOrg.1985(Tech.Rep.Ser.no.727)评估胰岛功能的五点OGTT 流程 快递问题件怎么处理流程河南自建厂房流程下载关于规范招聘需求审批流程制作流程表下载邮件下载流程设计 内分泌科通常用五点口服葡萄糖耐量试验(OGTT)和胰岛素释放试验(IRT)同时进行，合称“胰岛功能检查”。备注：内分泌医生ADA1997：尽管OGTT在诊断中价值很高，但不推荐常规使用，因其不便捷性，OGTT并未广泛用于诊断糖尿病。ADA2003：尽管OGTT被认为是诊断糖尿病的有效方法，但在临床中由于各种原因并未广泛使用，如不方便、重复性差、费用高。ADA2005：FPG或2小时OGTT（75g葡萄糖负荷）是适合的诊断方法。FPG是筛查糖尿病前期和糖尿病的优先方法。OGTT也被用于在高危人群中筛查糖尿病前期或糖尿病。ADA2007：筛查糖尿病前期或糖尿病，可单用FPG或2小时OGTT或二者同时应用。对IFG者OGTT能更好确定其患糖尿病风险。*ESC-EASD.EurHeartJ2007;28:88-136.2007ESC/EASD联合指南冠心病与糖尿病诊疗流程图2007年ESC/EASD联合指南建议：对2型糖尿病高危人群实施OGTT筛查2005年冠心病患者高血糖诊治中国专家共识冠心病患者合并高血糖诊治流程*2007年冠心病患者高血糖诊治中国专家共识 常规检测空腹血糖 当空腹血糖≤7mmol/L，常规检测OGTT 已知糖尿病者，常规检测餐后2小时血糖提倡尽早发现冠心病合并高血糖人群三个常规目录 指南推荐—— OGTT是诊断冠心病患者合并高血糖的必要手段 超出想象—— 冠心病患者不行OGTT检查漏诊大量糖代谢异常人群 临床现状—— 中国心内科OGTT推行现状堪忧 付诸行动—— 积极筛查两点OGTT，改善心血管预后 欧洲心脏调查:提醒心内科医生关注糖代谢异常的筛查与诊断EuropeanHeartJournal(2004)25,1880–1890AimTheobjectivebehindtheEuroHeartSurveyondiabetesandtheheartwastostudytheprevalenceofabnormalglucoseregulationinadultpatientswithcoronaryarterydisease(CAD).MethodsandresultsThesurveyengaged110centresin25countriesrecruiting4196patientsreferredtoacardiologistduetoCADoutofwhom2107wereadmittedonanacutebasisand2854hadanelectiveconsultation.Patientdatawerecollectedviaaweb-basedcaserecordform.Anoralglucosetolerancetest(OGTT)wasusedforthecharacterisationoftheglucosemetabolism.Thirty-onepercentofthepatientshaddiabetes.AnOGTTwasperformedonthe1920patientswithoutknowndiabetes,ofwhom923hadacuteand997hadastablemanifestationofCAD,respectively.InpatientswithacuteCAD,36%hadimpairedglucoseregulationand22%newlydetecteddiabetes.Inthestablegrouptheseproportionswere37%and14%.ConclusionThissurveydemonstratesthatnormalglucoseregulationislesscommonthanabnormalglucoseregulationinpatientswithCAD.OGTTeasilydisclosestheglucometabolicstateandshouldbearoutineprocedure.Theknowledgeofglucometabolicstateamongthesepatientsshouldinfluencetheirfuturemanagementbecauseithasgreatpotentialtoimprovetheoutcome.*欧洲心脏调查结果：“2/3现象”2/3冠心病患者合并糖代谢异常EuropeanHeartJournal(2004)25,1880–1890重要结果,图表形式欧洲心脏调查结果：“2/3现象”不行OGTT将漏诊约2/3糖代谢异常患者Background:Patientswithcoronaryarterydisease(CAD)andabnormalglucoseregulation(AGR)areathighriskforsubsequentcardiovascularevents,underliningtheimportanceofaccurateglucometabolicassessmentinclinicalpractice.Objective:Toinvestigatedifferentmethodstoidentifyglucosedisturbancesamongpatientswithacuteandstablecoronaryheartdisease.Methods:Consecutivepatientsreferredtocardiologistswereprospectivelyenrolledat110centresin25countries(n=4961).Fastingplasmaglucose(FPG)andglycaemia2haftera75-gglucoseloadwererequestedinpatientswithoutknownglucoseabnormalities(n=3362).GlucosemetabolismwasclassifiedaccordingtotheWorldHealthOrganizationandAmericanDiabetesAssociation(ADA;1997,2004)criteriaasnormal,impairedfastingglucose(IFG),impairedglucosetolerance(IGT)ordiabetes.Results:DataonFPGand2-hpost-loadglycaemiawereavailablefor1867patients,ofwhom870(47%)hadnormalglucoseregulation,87(5%)hadIFG,591(32%)hadIGTand319(17%)haddiabetes.IfclassificationhadbeenbasedontheADAcriterionfrom1997,theproportionofmisclassified(underdiagnosed)patientswouldhavebeen39%.TheADA2004criterionwouldhaveoverdiagnosed8%andunderdiagnosed33%ofthepatients,resultinginatotalmisclassificationrateof41%.Forethicalconcernsandpracticalreasons,oralglucosetolerancetest(OGTT)wasnotconductedin1495ofeligiblepatients.Thesepatientsweremoreoftenwomen,hadhigherageandwaistcircumference,andwerethereforemorelikelytohaveAGRthanthosewhowereincluded.Amodelbasedoneasilyavailableclinicalandlaboratoryvariables,includingFPG,high-densitylipoproteincholesterol,ageandthelogarithmofglycatedhaemoglobinA1c,misclassified44%ofthepatients,ofwhom18%wereoverdiagnosedand26%wereunderdiagnosed.Conclusion:AnOGTTisstillthemostappropriatemethodfortheclinicalassessmentofglucometabolicstatusinpatientswithcoronaryheartdisease.欧洲心脏调查结果：每2个FPG正常的CHD患者就有1个糖代谢异常(Bartnik,RydénetalHeart2007;93:72)欧洲心脏调查结论结论：调查结果表明，CAD患者中血糖调节异常更多见。OGTT检查更易明确患者糖代谢状况，应该将其作为常规检查。这是因为在此阶段进行干预，能够显著改善冠心病患者的预后。明确患者的血糖代谢情况，将直接影响对他们的治疗。EuropeanHeartJournal(2004)25,1880–1890中国心脏调查:回答对于中国冠心病患者中糖代谢状况的疑问Da-YiHu,etal.EuropeanHeartJournal2006;27:2573-2579.AimTheaimofthisarticleistocharacterizetheglucometabolicstateofpatientswithcoronaryarterydisease(CAD)inChina.MethodsandresultsThismulticentrestudyrecruited3513patientshospitalizedforCAD,ofwhom35.1%wereadmissionsforacuteCADand64.9%wereelectiveadmissionsforCAD.Atentry,1153patientshadknowntype2diabetesand97hadnewlydiagnoseddiabetes[fastingplasmaglucoselevel(FPG)7.0mmol/L].Oralglucosetolerancetests(OGTTs)performedintheremainingpatientsrevealedthat26.9%haddiabetesand37.3%hadimpairedglucoseregulation(IGR).Theprevalenceofabnormalglucoseregulation(AGR)wassimilarintheacuteandelectiveadmissionsgroups.Overall,theproportionofpatientswithdiagnoseddiabetesincreasedfrom32.8%atbaselineto52.9%post-OGTTanalysis.Intotal,87.4%ofpatientswithIGRand80.5%ofpatientswithdiabeteswouldhaveremainedundiagnosedifOGTTshadnotbeenperformed.ConclusionAGRiscommoninpatientswithCAD.TheprevalenceofAGRisunderestimatedbyFPGtestingalone.OGTTsshouldberoutinelyusedtoassesstheglucometabolicstateofpatientswithCAD.IndividualsidentifiedwithIGRortype2diabetesshouldreceivetreatmenttoreducetheprogressionofAGRandassociatedcomplications.中国心脏调查结果：“4/5现象”约4/5冠心病患者合并糖代谢异常Da-YiHu,etal.EuropeanHeartJournal2006;27:2573-2579.中国心脏调查结果：“4/5现象”不行OGTT将漏诊超过4/5的糖代谢异常患者Da-YiHu,etal.EuropeanHeartJournal2006;27:2573-2579.中国心脏调查结果：每3个FPG正常的CHD患者就有2个糖代谢异常Da-YiHu,etal.EuropeanHeartJournal2006;27:2573-2579.中国心脏调查结论结论：中国CAD患者合并糖代谢异常很常见，仅查FPG会使大量患者被漏诊，应该将OGTT作为CAD患者的常规检查，以评价其糖代谢状态。确诊为IGR（糖调节受损）和T2DM的患者应该通过降糖治疗减少糖调节异常以及相关并发症的进展。Da-YiHu,etal.EuropeanHeartJournal2006;27:2573-2579.欧洲/中国心脏调查结果对比:中国冠心病合并高血糖的形势更加严峻 同 异 冠心病患者合并糖代谢异常患病率高! 中国冠心病患者的糖代谢异常比例更高！ 冠心病患者合并的糖代谢异常存在大量漏诊! 中国冠心病人群合并的糖代谢异常的比例更高！ 不查OGTT，漏诊大量糖代谢异常个体不查OGTT，IGT漏诊率100% 不查OGTT，中国冠心病人群糖代谢异常漏诊率更高!目录 指南推荐—— OGTT是诊断冠心病患者合并高血糖的必要手段 超出想象—— 冠心病患者不行OGTT检查漏诊大量糖代谢异常人群 临床现状—— 中国心内科OGTT推行现状堪忧 付诸行动—— 积极筛查两点OGTT，改善心血管预后 心内科OGTT推行状况调研项目OGTT心内科Objectives：1.Toexplorecardiologists’perceptiononthecorrelationbetweendiseasesofcardiovascularsystemandPPG2.ToexploretheissuescardiologistsusuallyconsiderwhentheytreatpatientswithdiabetesorIGT3.TodeeplydigoutthereasonscardiologistsdonotprescribeOGTTasaroutineexaminationfortheirpatients4.TounderstandtheprocessofOGTTinhospitals5.ToprobeandrecommendfeasibleapproachesofincreasingOGTTquantityincardiologydept.研究方法访问对象：200名心内科医生医生职称：主治、副主任医师医院级别：26所三级医院调研范围：北京、沈阳、天津、济南、上海、杭州、成都、广州、武汉九所城市MethodologyStep1:qualitativeresearchApproach:DepthinterviewRespondent:cardiologistSeniority:vicechiefdoctor&attendingdoctorHospitallevel:tier3Citylevel:tier1andtier2Cities:Beijing,Shanghai,Jinan,TianjinStep2:quantitativeresearchApproach:F2FinterviewRespondent:cardiologistSeniority:vicechiefdoctor&attendingdoctorHospitallevel:tier3Citylevel:tier1andtier2Cities:consideringbothrationalityofsampledistributionandperformance-priceratio,wewilloffertwooptionsinthisstage.Thedetailswillbeexpatiatedinsamplingportion城市定性研究定量研究北京830上海830广州20杭州20济南520天津520成都20武汉20沈阳20总计26200仅有1/3的医生将OGTT作为心血管疾病患者的常规检查FPG5.6-7.0mmol/L有危险因素做OGTT或PPGFPG＜5.6mmol/L不进一步检查FPG5.6-7.0mmol/LFPG5.6-7.0mmol/LFPG＜5.6mmol/LFPG＜5.6mmol/L有危险因素做OGTT或PPGOGTT第三组第二组第一组OGTTOGTT或PPGPhysicianscanbesegmentedbytheiroperationonBGinspectionGroup1CheckFPGfirstWhenFPGisbetween5.6-7.0mmol/L,checkOGTTorrandomPPGwhenpatientshaverisks(fewofpatientcheck)WhenFPGislessthan5.6mmol/L,donotdoanyinspectionGroup2CheckFPGfirstWhenFPGisbetween5.6-7.0mmol/L,usuallycheckOGTTorrandomPPGWhenFPGislessthan5.6mmol/L,checkrandomPPGwhenpatientshaverisksGroup3DirectlyCheckFPGandPPGtogetherbyoral75gglucose80%的医生常规检查住院CHD病人的PPG问卷问题对没有糖代谢异常病史的CHD病人常规检查PPG吗？18%没有常规检查PPG82%常规检查PPGTophysicianswhodonotletCHDpatientwithoutIGTorD2recordcheckBGroutinely,therewillbeonlyaboutonethirdsuitablepatientsacceptingBGexaminationintheirhand当FPG<7.0mmol/L时，60%的医生没有把OGTT作为CHD病人的常规检查60%没有常规检查OGTT40%常规检查OGTT问卷问题：当没有糖耐量低下或糖尿病病史的冠心病病人的FPG＜7.0mmol/L时，你会让病人常规检查OGTT吗？仅有13%医生知道CHD合并糖代谢异常约为80%问卷问题你认为冠心病病人中，糖代谢异常的发生率是多少？N=200仅有4.5%医生知道CHD合糖代谢异常漏诊率高达80%问卷问题对于冠心病病人中，糖代谢异常的漏诊率你认为是多少？N=200仅有2/3的医生认为冠心病和糖尿病是心血管事件的等危症问卷问题：你认为非冠心病的糖尿病病人和没有糖耐量异常的冠心病病人发生心血管事件的风险哪个更大？7.5%9%15.5%68%N=200为什么不把OGTT作为常规检查呢？颜色字体在学术认识上的误区在临床实践中的担心目录 指南推荐—— OGTT是诊断冠心病患者合并高血糖的必要手段 超出想象—— 冠心病患者不行OGTT检查漏诊大量糖代谢异常人群 临床现状—— 中国心内科OGTT推行现状堪忧 付诸行动—— 积极筛查两点OGTT，改善心血管预后 误区NO.1诊断糖代谢异常仅仅是内分泌科医生的 职责 岗位职责下载项目部各岗位职责下载项目部各岗位职责下载建筑公司岗位职责下载社工督导职责.docx 。内分泌科 糖代谢异常早期无症状，不会主动去内分泌科就诊。 心内科医生更有机会发现糖代谢异常人群。 糖代谢异常的早期诊断和干预有助于改善心血管疾病预后。事实上……误区NO.2冠心病病人行OGTT检查，尚无指南可以遵循。权威指南推荐：OGTT是冠心病患者诊断糖代谢异常的必要手段WHO/IDF评议 报告 软件系统测试报告下载sgs报告如何下载关于路面塌陷情况报告535n,sgs报告怎么下载竣工报告下载 建议：OGTT是唯一的确定IGT人群的方法。2005年冠心病患者高血糖诊治中国专家共识指出：空腹血糖FPG<7.0mmol/L,常规行OGTT检查。2007ESC/EASD联合指南建议：对于未诊断糖尿病的冠心病病人常规行OGTT检查。临床担心NO.1简化的OGTT试验仍会让病人长时间等待，病人可以接受吗？会加重病人的经济负担吗？仅仅2h的等待，仅10元左右，使心血管事件发生率下降成为可能控制餐后血糖可以使心血管事件的发生率下降49%OGTT检查费用详单：75gGlu：1.5元抽血：1元×2血糖化验：5元×2共计：约13.5元是否需要控制血糖简化OGTT诊断糖代谢状况（IGT/DM）临床担心NO.2给病人处方OGTT检查，病人存在许多困惑——花多少钱？要多长时间？会有副作用吗？怎么做OGTT？什么是OGTT？为什么做OGTT？没有时间逐一解释，怎么办呢？——拜耳公司为您提供患者卡片，将帮助您向患者提供解释有关OGTT的相关内容患者问题解答：OGTT是口服葡萄糖耐量试验的简称……患者卡片实物图片拜耳公司帮助您向患者提供解释患者卡片解答患者心中的疑惑 问题一：我得的是冠心病，为什么要查血糖呢？ 回答冠心病和高血糖的密切关系 问题二：难道查空腹血糖不能检查出高血糖吗？ 回答OGTT检查的重要意义 问题三：什么是OGTT啊？要怎么做呢？ 解释OGTT的具体流程 问题四：做OGTT，我要注意什么呢？ OGTT的注意事项，患者的温馨小提示 问题五：做了OGTT，对我的治疗有什么帮助吗？ 明确血糖状态，有助治疗 问题六：做OGTT会很贵吗？ 打消患者的经济顾虑封面替换成DA封面备注：内分泌医生ADA1997：尽管OGTT在诊断中价值很高，但不推荐常规使用，因其不便捷性，OGTT并未广泛用于诊断糖尿病。ADA2003：尽管OGTT被认为是诊断糖尿病的有效方法，但在临床中由于各种原因并未广泛使用，如不方便、重复性差、费用高。ADA2005：FPG或2小时OGTT（75g葡萄糖负荷）是适合的诊断方法。FPG是筛查糖尿病前期和糖尿病的优先方法。OGTT也被用于在高危人群中筛查糖尿病前期或糖尿病。ADA2007：筛查糖尿病前期或糖尿病，可单用FPG或2小时OGTT或二者同时应用。对IFG者OGTT能更好确定其患糖尿病风险。**AimTheobjectivebehindtheEuroHeartSurveyondiabetesandtheheartwastostudytheprevalenceofabnormalglucoseregulationinadultpatientswithcoronaryarterydisease(CAD).MethodsandresultsThesurveyengaged110centresin25countriesrecruiting4196patientsreferredtoacardiologistduetoCADoutofwhom2107wereadmittedonanacutebasisand2854hadanelectiveconsultation.Patientdatawerecollectedviaaweb-basedcaserecordform.Anoralglucosetolerancetest(OGTT)wasusedforthecharacterisationoftheglucosemetabolism.Thirty-onepercentofthepatientshaddiabetes.AnOGTTwasperformedonthe1920patientswithoutknowndiabetes,ofwhom923hadacuteand997hadastablemanifestationofCAD,respectively.InpatientswithacuteCAD,36%hadimpairedglucoseregulationand22%newlydetecteddiabetes.Inthestablegrouptheseproportionswere37%and14%.ConclusionThissurveydemonstratesthatnormalglucoseregulationislesscommonthanabnormalglucoseregulationinpatientswithCAD.OGTTeasilydisclosestheglucometabolicstateandshouldbearoutineprocedure.Theknowledgeofglucometabolicstateamongthesepatientsshouldinfluencetheirfuturemanagementbecauseithasgreatpotentialtoimprovetheoutcome.*重要结果,图表形式Background:Patientswithcoronaryarterydisease(CAD)andabnormalglucoseregulation(AGR)areathighriskforsubsequentcardiovascularevents,underliningtheimportanceofaccurateglucometabolicassessmentinclinicalpractice.Objective:Toinvestigatedifferentmethodstoidentifyglucosedisturbancesamongpatientswithacuteandstablecoronaryheartdisease.Methods:Consecutivepatientsreferredtocardiologistswereprospectivelyenrolledat110centresin25countries(n=4961).Fastingplasmaglucose(FPG)andglycaemia2haftera75-gglucoseloadwererequestedinpatientswithoutknownglucoseabnormalities(n=3362).GlucosemetabolismwasclassifiedaccordingtotheWorldHealthOrganizationandAmericanDiabetesAssociation(ADA;1997,2004)criteriaasnormal,impairedfastingglucose(IFG),impairedglucosetolerance(IGT)ordiabetes.Results:DataonFPGand2-hpost-loadglycaemiawereavailablefor1867patients,ofwhom870(47%)hadnormalglucoseregulation,87(5%)hadIFG,591(32%)hadIGTand319(17%)haddiabetes.IfclassificationhadbeenbasedontheADAcriterionfrom1997,theproportionofmisclassified(underdiagnosed)patientswouldhavebeen39%.TheADA2004criterionwouldhaveoverdiagnosed8%andunderdiagnosed33%ofthepatients,resultinginatotalmisclassificationrateof41%.Forethicalconcernsandpracticalreasons,oralglucosetolerancetest(OGTT)wasnotconductedin1495ofeligiblepatients.Thesepatientsweremoreoftenwomen,hadhigherageandwaistcircumference,andwerethereforemorelikelytohaveAGRthanthosewhowereincluded.Amodelbasedoneasilyavailableclinicalandlaboratoryvariables,includingFPG,high-densitylipoproteincholesterol,ageandthelogarithmofglycatedhaemoglobinA1c,misclassified44%ofthepatients,ofwhom18%wereoverdiagnosedand26%wereunderdiagnosed.Conclusion:AnOGTTisstillthemostappropriatemethodfortheclinicalassessmentofglucometabolicstatusinpatientswithcoronaryheartdisease.AimTheaimofthisarticleistocharacterizetheglucometabolicstateofpatientswithcoronaryarterydisease(CAD)inChina.MethodsandresultsThismulticentrestudyrecruited3513patientshospitalizedforCAD,ofwhom35.1%wereadmissionsforacuteCADand64.9%wereelectiveadmissionsforCAD.Atentry,1153patientshadknowntype2diabetesand97hadnewlydiagnoseddiabetes[fastingplasmaglucoselevel(FPG)7.0mmol/L].Oralglucosetolerancetests(OGTTs)performedintheremainingpatientsrevealedthat26.9%haddiabetesand37.3%hadimpairedglucoseregulation(IGR).Theprevalenceofabnormalglucoseregulation(AGR)wassimilarintheacuteandelectiveadmissionsgroups.Overall,theproportionofpatientswithdiagnoseddiabetesincreasedfrom32.8%atbaselineto52.9%post-OGTTanalysis.Intotal,87.4%ofpatientswithIGRand80.5%ofpatientswithdiabeteswouldhaveremainedundiagnosedifOGTTshadnotbeenperformed.ConclusionAGRiscommoninpatientswithCAD.TheprevalenceofAGRisunderestimatedbyFPGtestingalone.OGTTsshouldberoutinelyusedtoassesstheglucometabolicstateofpatientswithCAD.IndividualsidentifiedwithIGRortype2diabetesshouldreceivetreatmenttoreducetheprogressionofAGRandassociatedcomplications.Objectives：1.Toexplorecardiologists’perceptiononthecorrelationbetweendiseasesofcardiovascularsystemandPPG2.ToexploretheissuescardiologistsusuallyconsiderwhentheytreatpatientswithdiabetesorIGT3.TodeeplydigoutthereasonscardiologistsdonotprescribeOGTTasaroutineexaminationfortheirpatients4.TounderstandtheprocessofOGTTinhospitals5.ToprobeandrecommendfeasibleapproachesofincreasingOGTTquantityincardiologydept.MethodologyStep1:qualitativeresearchApproach:DepthinterviewRespondent:cardiologistSeniority:vicechiefdoctor&attendingdoctorHospitallevel:tier3Citylevel:tier1andtier2Cities:Beijing,Shanghai,Jinan,TianjinStep2:quantitativeresearchApproach:F2FinterviewRespondent:cardiologistSeniority:vicechiefdoctor&attendingdoctorHospitallevel:tier3Citylevel:tier1andtier2Cities:consideringbothrationalityofsampledistributionandperformance-priceratio,wewilloffertwooptionsinthisstage.Thedetailswillbeexpatiatedinsamplingportion城市定性研究定量研究北京830上海830广州20杭州20济南520天津520成都20武汉20沈阳20总计26200PhysicianscanbesegmentedbytheiroperationonBGinspectionGroup1CheckFPGfirstWhenFPGisbetween5.6-7.0mmol/L,checkOGTTorrandomPPGwhenpatientshaverisks(fewofpatientcheck)WhenFPGislessthan5.6mmol/L,donotdoanyinspectionGroup2CheckFPGfirstWhenFPGisbetween5.6-7.0mmol/L,usuallycheckOGTTorrandomPPGWhenFPGislessthan5.6mmol/L,checkrandomPPGwhenpatientshaverisksGroup3DirectlyCheckFPGandPPGtogetherbyoral75gglucoseTophysicianswhodonotletCHDpatientwithoutIGTorD2recordcheckBGroutinely,therewillbeonlyaboutonethirdsuitablepatientsacceptingBGexaminationintheirhand颜色字体拜耳公司帮助您向患者提供解释