Medical Science and Health
醫(yī)學(xué)與健康

Text

Something about the treatment of Diabetes

One recent study that was published in the January 2004 issue of the Journal of the American Medical Association, found that just 12 percent of people with diabetes have met the doctors' recommended guidelines for blood glucose, lipids and blood pressure levels. Those people, failing to meet these goals, are at an extremely high risk for heart disease, which is the leading cause of death for people with diabetes.

According to data released at the American Diabetes Association's (ADA's) 64th Annual Scientific Sessions in June, most diabetes specialists worldwide do not regard diabetes as a "coronary equivalent". That is, they don't treat problems such as high cholesterol as aggressively in people who have diabetes as they do in people who have heart disease, even though people who have diabetes are as much at risk for a coronary event as someone without diabetes who has already had a heart attack.

Other studies show that doctors fail to treat high blood pressure aggressively enough in people who have diabetes, and that nearly half of all people with diabetes who are treated for high blood pressure cannot succeed in keeping their blood pressure levels "at goal". More than 70 percent of all people with diabetes have high blood pressure, though many of them do not even know it.

What makes this more complex is the reality that many other obstacles hold people from keeping their own blood pressure, lipids and blood glucose levels in check. These problems might include the patient's failure to stick to a treatment plan, a lack of social support and the fact that many people who have diabetes face various disease conditions that can become overwhelming.

Because diabetes is such a complex disease, it is often difficult for people to see how to take a few simple steps to vastly improve their health. That's why the American Diabetes Association has developed a new tool, known as Diabetes Personal Health Decisions (Diabetes PHD), which can immediately show people the specific benefits they would achieve by losing a specific number of pounds, or by lowering blood glucose, cholesterol or blood pressure levels by varying amounts.

This tool allows people who have diabetes-and even those who are at risk for developing it-to enter personal health information such as age, sex, height, race, weight, family history, medications and a variety of blood values onto a Web site. The program then gives back an accurate risk profile that spells out what that person can do to lower his or her risks by changing specific health parameters such as weight, blood pressure or cholesterol. People will have free access to the Diabetes PHD on the ADA's Web site later this year.

But retrieving a report from Diabetes PHD is only the first step. The information provided can help emphasize the benefits of different health and lifestyle changes, but it is up to health care providers and the people they treat to follow through on Diabetes PHD data with action.

Diabetes is a serious and life-threatening disease, but it is one that we know how to treat, how to delay or prevent it. And that's a goal worth working towards in the future.

1. According to one recent study published in the Journal of the American Medical Association, what is the percentage of those people with diabetes who have not met recommended guidelines for blood glucose, lipids and blood pressure levels? ______
[A]　70%
[B]　30%
[C]　12%
[D]　88%

2. According to the passage, doctors have not been active enough in treating ____of the patients with diabetes.
[A] their heart disease
[B] their high cholesterol
[C] their high blood pressure
[D] both B and C

3. In real life, many people can not succeed in keeping their own blood pressure, lipids and blood glucose at healthy levels as a result of many obstacles except____.
[A] the patients can not stick to a treatment plan
[B] there is a lack of family support
[C] the patients have to face many other disease conditions
[D] the society does not give enough support

4. By developing Diabetes PHD, the American Diabetes Association aims at ______.
[A] helping the people with diabetes in analyzing their physical conditions
[B] offering people some accurate health parameters
[C] helping emphasize the importance and benefits of different health and lifestyle changes
[D] directing doctors in their treatment of the diabetes

5. The author's attitude towards the present treatment of diabetes is ______.
[A] critical
[B] objective
[C] positive
[D] optimistic答案與題解

1. [D]
文章的第一段說(shuō)僅僅有12%的糖尿病患者的血糖、血脂和血壓的指標(biāo)達(dá)到了醫(yī)生建議的標(biāo)準(zhǔn)，換算一下，沒(méi)達(dá)到標(biāo)準(zhǔn)的應(yīng)該是88%。

2. [D]
文章的二、三段對(duì)詞此進(jìn)行了詳細(xì)的交代，第二段指出，醫(yī)生們沒(méi)有像對(duì)待心臟病患者那樣、積極治療糖尿病患者的高膽固醇；第三段第一句話(huà)就指出了醫(yī)生沒(méi)有對(duì)糖尿病患者的高血壓進(jìn)行積極的治療。

3. [B]
文章第四段說(shuō)到妨礙人們控制血壓、血脂和血糖的一些障礙，包括不能按照方案堅(jiān)持治療、缺乏社會(huì)的支持、要面對(duì)合并多種疾病的事實(shí)，但沒(méi)有提到家庭支持。

4. [C]
從文章的第五段到第七段一直在說(shuō)開(kāi)發(fā)"糖尿病PHD"的目的，選項(xiàng)[A]和[B]講的是這一工具的功能，[D]不符合文意，只有[C]是說(shuō)的研發(fā)糖尿病的目的。在文中這一目的在五、六、七段均提到了。

5. [B]
文章的第二和第三段指出了糖尿病治療過(guò)程中的一些不足，如對(duì)高膽固醇和高血壓沒(méi)有給予積極的治療，但在文章的比較后一段也肯定了目前醫(yī)學(xué)在治療糖尿病方面作出的貢獻(xiàn)，如總結(jié)了一些治療方法，知道如何預(yù)防和延緩它，所以說(shuō)作者的態(tài)度是客觀的。

Words

1. glucose 　葡萄糖
2. lipid 　脂質(zhì), 油脂
3. coronary 　冠心病的，冠狀動(dòng)脈的
4. cholesterol 　膽固醇
5. risk profile 　風(fēng)險(xiǎn)預(yù)測(cè)

Notes

1. 第三段的"keeping their blood pressure levels ‘a(chǎn)t goal'"是指"將他們的血壓控制在合格標(biāo)準(zhǔn)之內(nèi)"。

2. 第四段的"What makes this more complex is the reality that many other obstacles hold people from keeping their own blood pressure, lipids and blood glucose levels in check."這句話(huà)包含了兩個(gè)從句，一個(gè)是由what引導(dǎo)的主語(yǔ)從句，另外一個(gè)是由 that引導(dǎo)的同位語(yǔ)從句，先行詞是reality.

3. 第四段的"...who have diabetes face various disease conditions that can become overwhelming." 中的"that can become overwhelming"是個(gè)定語(yǔ)從句，先行詞是disease conditions，而其中又包含了一個(gè)以conditions為先行詞，由that引導(dǎo)的定語(yǔ)從句。

4. 第六段的spell out意思使"清楚地說(shuō)明"。

5. 第七段的"..., but it is up to health care providers and the people they treat to follow through on Diabetes PHD data with action."中的up to表示"由......決定，取決于......"。"they treat to follow through on Diabetes PHD data with action"是個(gè)定語(yǔ)從句，先行詞是people，省去了引導(dǎo)詞that。

課文參考譯文

糖尿病治療二三事

2004年1月份《美國(guó)醫(yī)學(xué)會(huì)雜志》刊登了一項(xiàng)比較近的研究報(bào)告。報(bào)告發(fā)現(xiàn)，僅僅12％的糖尿病患者的血糖、血脂和血壓的指標(biāo)達(dá)到了醫(yī)生建議的標(biāo)準(zhǔn)。沒(méi)有達(dá)到這些指標(biāo)的人患心臟病的風(fēng)險(xiǎn)極高，而心臟病也是糖尿病患者的首要死因。

在6月份召開(kāi)的第64屆科學(xué)年會(huì)上，美國(guó)糖尿病協(xié)會(huì)（ADA）發(fā)表的數(shù)據(jù)表明：全世界大部分糖尿病專(zhuān)科醫(yī)生都沒(méi)有把糖尿病看作"冠心病等危癥"。也就是說(shuō)，雖然糖尿病患者發(fā)生冠脈事件的風(fēng)險(xiǎn)與已有過(guò)一次心臟病發(fā)作的非糖尿病患者相當(dāng)，但是，專(zhuān)科醫(yī)生們未能像對(duì)待心臟病患者那樣、對(duì)糖尿病患者的高膽固醇等情況予以積極治療。

另外的一些研究表明，醫(yī)生們對(duì)糖尿病患者的高血壓沒(méi)有給予足夠積極的治療，而接受高血壓治療的全部糖尿病患者幾近一半未能將他們的血壓保持在"合格標(biāo)準(zhǔn)之內(nèi)"。在全部糖尿病患者中，患有合并高血壓的超過(guò)70％，盡管他們中的許多人甚至并不知情。

使這種情況復(fù)雜化的是，現(xiàn)實(shí)中還存在許多妨礙人們控制血壓、血脂和血糖水平的障礙。這些問(wèn)題可能包括病人不能堅(jiān)持按照方案治療、缺乏社會(huì)支持、甚至許多糖尿病患者還要面對(duì)難以控制的多種合并疾病的糾纏。

糖尿病是如此復(fù)雜的一種病，人們常常無(wú)法得知如何通過(guò)幾個(gè)簡(jiǎn)單步驟來(lái)顯著改善健康狀況。這就是ADA開(kāi)發(fā)一個(gè)新的"工具"--稱(chēng)為"糖尿病個(gè)人健康判定程序"（簡(jiǎn)稱(chēng) 糖尿病PHD）--的原因。該程序能立即告知患者通過(guò)減少特定磅數(shù)的體重或降低不同數(shù)量的血糖、膽固醇或血壓，他們就可能獲得切實(shí)的益處。

有了這個(gè)"工具"，糖尿病患者--以及那些有患上糖尿病危險(xiǎn)的人--可以把年齡、性別、身高、民族、體重、家族史、藥物治療情況和血液的各種化驗(yàn)值等個(gè)人健康信息輸入到一個(gè)網(wǎng)站上。接著該程序就會(huì)反饋一個(gè)精確的風(fēng)險(xiǎn)預(yù)測(cè)，清楚明了地告訴人們?nèi)绾瓮ㄟ^(guò)改變體重、血壓或膽固醇等特定的健康參數(shù)來(lái)降低他/她患糖尿病的風(fēng)險(xiǎn)。2004年晚些時(shí)候，人們就可以在ADA網(wǎng)站上免費(fèi)使用"糖尿病PHD"了。

不過(guò)，從"糖尿病PHD"檢索一份報(bào)告還只是第一步。報(bào)告提供的信息可以幫助突出健康狀況和生活方式改善的不同程度可以帶來(lái)的諸多好處，但是，一切還得取決于保健醫(yī)生們和他們治療的病人們按照"糖尿病PHD"提供的數(shù)據(jù)采取了怎樣的行動(dòng)。

雖然糖尿病是一種嚴(yán)重的和威脅生命的疾病，但我們已經(jīng)知道如何去治療它。我們甚至知道如何延緩或預(yù)防它。而那也正是一個(gè)值得我們?yōu)橹�工作的目�?biāo)。