| 摘要: | 根據2015年世界衛生組織(WHO)所發布之全球前十大死因，以及我國衛生福利部所發布之我國前十大死因中，顯示糖尿病分別為列第6與第5，而在2017年國際糖尿病聯盟(IDF)發布的第8版全球糖尿病地圖(IDF Diabetes Atlas)統計中，2017年世界上大約有4.25億成人罹患糖尿病，流行病學家預估到了2045年糖尿病患者可能達到6.29億，至2017年我國目前大約有200多萬名糖尿病患，流行病學家推估我國每年以2萬5千名的速度持續增加，由此可知糖尿病已經成為現階段世界各國主要的公共衛生議題。
糖尿病患者如果沒有控制好會引起各種嚴重的併發症，糖尿病的併發症大致上可分為微血管(microvascular)疾病和大血管(macrovascular)疾病，可能會引發的併發症包括:眼睛受損（視網膜病變導致失明）、腎臟功能受損（導致腎衰竭或是其他腎臟病¬）、神經末梢受損(神經病變導致糖尿病足，有可能導致截肢的嚴重感染）等。大血管並發症則包括了心血管疾病例如:心臟病的發作、血管阻塞而導致中風以及血管阻塞導致腿部血流不足等。
糖尿病不光是簡單的健康危機；更是一個全球性的嚴重社會災難。由於糖尿病是一種慢性內分泌代謝性疾病，因此糖尿病與其相關的併發症的直接醫療費用，也造成患者無法工作，除了給患者個人帶來痛苦外，也使患者的家庭陷入貧困，更是給國家付出龐大的經濟損失。全世界的政府都在努力承擔糖尿病相關的醫療費用，主要的費用包括醫院與門診醫護，以及胰島素藥物，以北美洲為例，每年花費大約3500~4000億美金。
如何有效的減少糖尿病患者以及其日後可能產生之併發症，除了在醫療照護應努力改善糖尿病的控制，減少併發症的發生外，也應加強民眾的衛生教育知識以預防糖尿病的發生，或儘早篩檢出疾病輕微的潛伏糖尿病病患，以避免疾病惡化後，造成民眾生活品質的降低，及醫療支出的沈重負擔。
本研究希望藉由生理生化的檢測項目，依照性別、年齡、工作、教育程度去比較不同生化檢查項目，對可能罹患糖尿病之患者及可能發生之併發症進行風險上的管理，並探討罹患糖尿病是否亦引發其他相關疾病，如肝臟相關疾病、腎臟相關疾病、心血管相關疾病等是否有相關性，以提供疾病早期的預知與預防疾病的形成。
According to the top ten causes of death in the world published by the World Health Organization (WHO) in 2015, and the top ten causes of death issued by the Ministry of Health and Welfare in Republic of Taiwan, diabetes is ranked 6th and 5th respectively.According to the IDF Diabetes Atlas released by the Alliance (IDF), there are about 425 million adults in the world have diabetes until 2017. The epidemiologists estimate that in 2045, the diabetes patients may reach 629 million. In Taiwan, there are currently more than 2 million people with diabetes. Epidemiologist’s estimate that diabetes continue to increase at the rate of 25,000 per year. The diabetes has become the main public health issue in the world at this stage.
Diabetes patients who are not well controlled can cause serious complications. The complications of diabetes can be roughly divided into micro vascular diseases and macro vascular diseases. Possible complications include: Eye damage (retina) Lesions cause blindness, kidney function is impaired (resulting in kidney failure or other kidney disease), nerve endings are damaged (neurological lesions lead to diabetic foot, and may cause serious infection of amputation). Macro vascular complications include cardiovascular diseases such as the onset of heart disease, vascular obstruction leading to stroke, and vascular obstruction leading to insufficient blood flow to the legs.
Diabetes is not only a simple health crisis; it is also a global serious social disaster. Because diabetes is a chronic endocrine and metabolic disease, the direct medical cost of diabetes and its related complications also causes the patient to be unable to work. In addition to causing pain to the individual, the family is also impoverished, and the country is huge economic loss to the country.Governments around the world are struggling to pay for diabetes-related medical expenses. The main costs include hospital and outpatient care, as well as insulin drugs. In North America, for example, it costs about $350-400 billion per year.
The effectively reduce the number of diabetic patients and their possible complications in the future is to improve the control of diabetes and reduce the incidence of complications in medical care. It is also necessary to strengthen the public health education knowledge to prevent the occurrence of diabetes, or to screen as early as possible A latent diabetic patient with mild disease is detected to avoid a deterioration in the quality of life of the population and a heavy burden of medical expenses.
This study hopes to compare the different biochemical examination items according to gender, age, work and education level through physiological and biochemical testing programs, to manage the risk of patients with diabetes and possible complications, and to explore whether diabetes is present. It also causes other related diseases and diseases, such as liver-related diseases, kidney-related diseases, and cardiovascular-related diseases, to provide predictive and preventive diseases. |
