糖尿病通常是指一系列
Diabetes refers to a group of conditions characterized
由血液含糖量高引起的特征疾病
by high levels of blood glucose, commonly
显现特征被称为高血糖
known as blood sugar.
葡萄糖是通过消化食物中碳水化合物获取的
Glucose comes from digestion of carbohydrates in food,
然后被运输到血液中
and is carried by the bloodstream
到达身体各个组织
to various body tissues.
但是葡萄糖仅凭自己无法穿过细胞膜进入细胞
But glucose can not cross the cell membrane to enter the cells on its own;
要想进入细胞
to do so,
它需要胰腺产生的一种激素——胰岛素来协助
it requires assistance from a hormone producedby the pancreas called insulin.
胰岛素与胰岛素靶细胞上的受体结合
Binding of insulin to its receptor
触发信号分级调节
on a target cell triggers a signaling cascade that brings
让葡萄糖转运蛋白进入细胞膜
glucose transporters to the cell membrane,
并创建通道 使得葡萄糖进入细胞
creating passageways for glucose to enter the cells.
在大多数组织 例如肌肉组织中
In most tissues, muscles for example,
葡萄糖是主要能源物质
glucose is used as an energy source,
在肝脏和脂肪组织中
while in the liver and adipose tissue,
葡萄糖还能被作为糖原和脂肪储存 为之后使用
it is also stored for later use, in the form of glycogen and fats.
当身体处于禁食状态时
When the body is in the fasted state,
肝脏就会将葡萄糖分解到血液中
the liver produces and secretes glucose into the blood,
同时脂肪组织释放游离脂肪酸到肝脏
while adipose tissues release free fatty
这些脂肪酸转变成
acids to the liver where they are converted
额外的代谢燃料
into additional metabolic fuel.
糖尿病发生于胰岛素缺失或者分泌受阻时
Diabetes happens when insulin is either deficient or its action is compromised.
没有胰岛素 葡萄糖无法进入细胞
Without insulin, glucose can not enter the cells;
葡萄糖长时间在血液中
it stays in the blood, causing high
就会提高血糖浓度
blood sugar levels.
糖尿病分为两类
There are 2 major types of diabetes.
第一类是胰腺无法分泌足够的胰岛素
Type 1 is when the pancreas does not produce enough insulin;
第二类是细胞无法很好地结合胰岛素
and type 2 is when the body’s
它们对胰岛素有抵制作用
cells do not respond well to insulin – theyare insulin-resistant.
两类糖尿病都可能
Both types are caused by a combination
由基因和环境导致
of genetic and environmental factors but genetics
但是基因主要影响第一类糖尿病
plays a major role in type 1,
而第二类糖尿病主要由不良生活方式导致
while lifestyle is a predominant risk factor for type 2.
所以 第一类糖尿病通常突然发生在幼儿时期
For this reason, type 1 diabetes usually starts suddenly
而第二类往往在成人时期
in childhood, while type 2 progresses
逐渐形成
gradually during adulthood,
所谓的糖尿病前期阶段 正是血糖浓度水平的分界线
going through a so called pre-diabetic stage, which is defined
此时血糖浓度高于正常水平但低于糖尿病水平
as borderline blood sugar levels: higher than normal, but lower than diabetic.
糖尿病前期症状非常普遍
Pre-diabetes is very common,
它们不一定会发展成糖尿病
and while not always developing into full-blown diabetes,
但随着时间推移 它同样会损害身体
over time, it can cause much the same damage to the body.
不健康的生活方式是前期糖尿病的诱因
Unhealthy lifestyle is the trigger
也是前期糖尿病发展成第二类糖尿病
of pre-diabetes and the main driving force behind its progression
的主要原因
to diabetes type 2.
肥胖和缺乏运动是关键因素
The key factors are obesity and physical inactivity.
肥胖有两种方式
There are at least 2 ways
导致胰岛素受阻和高血糖
by which obesity can cause insulin resistance and high blood glucose.
第一种 在肥胖状态下
First, in obesity,
细胞必须超负荷地吸收处理更多的营养 导致身体压力增大
fat cells have to process more nutrients than they can manage and become stressed.
从而释放炎症介质 例如细胞因子
As a result, they release inflammatory mediators,known as cytokines.
细胞因子会介入信号分级调节
Cytokines interfere with the signaling cascade
阻碍胰岛素的结合
by insulin receptor, blocking the action of insulin,
从而降低细胞对胰岛素的反应
thereby causing the cells to becomeless responsive to insulin. Second,
另一种方式是过多的组织向肝脏
excess adipose tissue releases abnormally large amount
释放大量游离脂肪酸
of free fatty acids to the liver
而这种情况一般发生在禁食状态下
– an event that normally happens only when the body is fasting.
这使得肝脏误以为要分泌更多葡萄糖到血液中
This tricks the liver into producing and releasing more glucose into the blood.
高血糖更一步促进分泌胰岛素
High blood glucose stimulates further insulinsecretion.
高含量胰岛素使机体组织对其反应迟钝
Constant high insulin levels de-sensitizebody tissues, causing insulin insensitivity.
腹内脂肪分泌更多脂肪酸和细胞因子
Intra-abdominal fat appears to produce more fatty acids and cytokines,
因此
and therefore has
对血糖的影响比皮下脂肪或外部脂肪要严重得多
more severe effect on blood glucose, thansubcutaneous, or peripheral fat.
因此
For this reason,
腰围大比体重指数高影响更大
large waist size is a greater risk factor than high body mass index.
久坐不仅对增重有间接影响
Sedentary lifestyle, apart from having indirect effect
它本身还对
by causing weight gain, has its own
阻碍胰岛素有直接影响
direct impact on insulin resistance.
这是因为 维持健康的血糖浓度需要体力活动
This is because physical activity is required to maintain healthy blood sugar levels.
体力活动促进肌肉的能量需求
Physical activity increases energy demand by the muscles,
这样会消耗血液中的葡萄糖
which consume glucose from
以及肝脏和脂肪组织中储存的葡萄糖
the blood, and subsequently from glucose storage in the liver and adipose tissue.
高能量消耗有助于
High energy expenditure helps to clear
更快地清除每餐后的 血糖峰值
up faster the spikes of blood glucose that follow every meal.
高能量需求还能促进细胞与胰岛素反应 提高敏感度
High energy demand also promotes better cellular response to insulin, increasing insulin sensitivity.
研究表明 即使每餐后
Studies have shown that physical inactivity,
短时间内身体不活动
even for a short period of time, results in
也会导致血糖持续升高
consistently higher spikes of blood sugar after meals,
引发糖尿病前期
which can trigger pre-diabetic
身体不活动影响健康的身体或加速糖尿病的转变
changes in healthy individuals, or speed up transition from pre-diabetes to diabetes.
更重要的是 这不仅发生在超重的病人身上
More importantly, this happens not only to over-weight patients,
还会发生在一些
but also to people with
看起来体重正常的人身上
seemingly healthy weight.
这可能是因为
This is probably
缺乏运动会导致肌肉减少 脂肪增多
because inactivity reduces muscle mass and replaces it with adipose tissue,
因此对血糖有严重影响
thus having serious effects on blood sugar levels
尽管此时整体仍保持 正常体重
while still maintaining an overall normal weight.
为了预防糖尿病
The bottom line is, in order to prevent diabetes,
我们起码要把体重管理
weight management must be combined with physical
与运动锻炼结合起来
activity or exercise.
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