Diabetes Care:1型糖尿病患者严重低血糖和酮症酸中毒发病率和微血管并发症患病率

2019-09-24 xing.T MedSci原创

由此可见,对于1型糖尿病成年人,血糖控制似乎比先前估计的要差。随着HbA1c的增加,所有并发症的发生率均增加。与HbA1c<7%相比,HbA1c≥9%分别与SH和DKA的发病率高出2倍和12倍有关。与较年长的成年人相比,较年轻的成年人血糖控制不佳相关的SH和DKA风险更高。

近日,糖尿病领域权威杂志Diabetes Care上发表了一篇研究文章,研究人员通过评估按年龄和血糖控制分层的急性和微血管并发症,来确定美国电子健康记录数据库中1型糖尿病成年人的疾病负担。

这是一项针对1型糖尿病成年人进行的回顾性观察研究(2014年7月1日至2016年6月30日),这些患使用经过验证的算法进行分类,疾病持续时间≥24个月,在12个月的基线期内未怀孕,并且具有一种或多种胰岛素处方和一次或多次HbA1c测量值。研究人员按年龄(18-25、26-49、50-64和≥65岁)和血糖控制(HbA1c<7%、7至<9%和≥9%)对人口统计学特征、急性并发症(严重低血糖[SH]、糖尿病性酮症酸中毒[DKA])和微血管并发症(神经病、肾病和视网膜病)进行分层。

31430名患者中,约20%的患者HbA1c<7%。老年患者的HbA1c值低于年轻患者(P<0.001)。对于HbA1c<7%、7至<9%和≥9%的血糖控制不佳患者SH(4.2%、4.0%和8.3%)和DKA(1.3%、2.8%和15.8%)的年度发生率最高(均P<0.001),并且神经病和肾病患病率较高(均为P<0.001)。

由此可见,对于1型糖尿病成年人,血糖控制似乎比先前估计的要差。随着HbA1c的增加,所有并发症的发生率均增加。与HbA1c<7%相比,HbA1c≥9%分别与SH和DKA的发病率高出2倍和12倍有关。与较年长的成年人相比,较年轻的成年人血糖控制不佳相关的SH和DKA风险更高。 

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  5. 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createdTime=Thu Dec 19 22:57:00 CST 2019, time=2019-12-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1758163, encodeId=91701e58163ae, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Wed Nov 20 04:57:00 CST 2019, time=2019-11-20, status=1, ipAttribution=)]
  6. 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    2019-11-20 丁鹏鹏

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阿斯利康本周一宣布,美国食品和药物管理局(FDA)发布了一份完整的回复函。FDA认为,当单独使用胰岛素不能提供足够的血糖控制时,SGLT2抑制剂Farxiga(达格列嗪)作为胰岛素的辅助治疗不能改善1型糖尿病患者的血糖控制。

NEJM:替利珠单抗与1型糖尿病风险

由此可见,替利珠单抗可延迟高风险参与者进展为临床1型糖尿病。