我国糖尿病患者达1.14亿!但降压比降糖更重要

2017-05-17 毛圆圆 健康时报网

近日,由北京大学糖尿病中心、《中国糖尿病杂志》社联合主办的“2017北大糖尿病论坛”在北京举办。今年的主题是“糖尿病药物治疗新进展——从分子到策略”。糖尿病并发症中死亡率最高的就是心血管病变!挑战:血压升高会增心血管风险我国已确诊的糖友达1.14亿,然而2010年我国的高血压患者就已经超过了2亿!我国不仅是个糖尿病大国,也是一个高血压的大国。广东省人民医院心血管内科主任医师陈纪言表示:“有资料显示

近日,由北京大学糖尿病中心、《中国糖尿病杂志》社联合主办的“2017北大糖尿病论坛”在北京举办。今年的主题是“糖尿病药物治疗新进展——从分子到策略”。

糖尿病并发症中死亡率最高的就是心血管病变!

挑战:血压升高会增心血管风险

我国已确诊的糖友达1.14亿,然而2010年我国的高血压患者就已经超过了2亿!我国不仅是个糖尿病大国,也是一个高血压的大国。

广东省人民医院心血管内科主任医师陈纪言表示:“有资料显示,我国糖尿病患者中40%~60%伴有高血压,英国前瞻性糖尿病研究(UKPDS)对新诊断糖尿病患者进行了4~6年的随访后,得出结果,相比于血压正常的糖尿病患者,糖尿病合并高血压的患者全因死亡率增加了7.2倍,心血管事件风险增高了75%,大血管病变作为糖尿病患者死亡的主要原因,占到了65%~75%。这提示我们血压升高会显着增加糖尿病患者心血管风险。”

现状:死亡风险未降低

虽然,已经明确了高血压与糖尿病心血管风险是正比关系,但对糖友来说,最佳的血压目标值却在不同地区有着较大争议。陈纪言指出,2013年欧洲高血压学会(ESH)指南推荐糖友血压控制水平为140/85mmHg,2017年加拿大高血压教育计划(CHEP)指南推荐的指标为130/80mmHg,2017年美国糖尿病学会(ADA)推荐心血管高危患者的控制目标为130/80mmHg,低危患者的目标为140/90mmHg,而日本、中国台湾地区在2014年高血压指南与中国大陆地区2017年高血压指南中均推荐130/80mmHg为控制目标。

另外,北京大学人民医院内分泌科主任医师纪立农说,虽然在过去的20年里,随着糖尿病机制研究的进展,新药物研发的速度呈指数上升趋势,糖尿病的防治人员在减轻患者痛苦、提高患者生存率上做出了重要贡献,与高血糖有关的糖尿病并发症也有了显着的下降。尽管治疗手段有了明显的进步,但是2型糖尿病的死亡风险仍较正常人显着增加了,严格的血糖控制对改善糖友心血管病变发生风险的作用并不显着。

展望:前景值得期待

“针对糖尿病患者何时启动降压治疗、中国人最佳的血压目标值是多少等问题,我国学者将拟启动血压正常高值或临界高血压合并2型糖尿病人群降压干预研究(IPAD),研究启动后将会给糖尿病合并高血压的治疗带来更多的有益证据。”陈纪言说。

纪立农也表示,虽然目前国内外指南的制定仍然以血糖控制为中心,然而未来糖尿病治疗路径将从以控制血糖中心转向以改善心血管和死亡结局为中心兼顾控制血糖的方向转变,开展以心血管疾病防控为核心的降糖药物应用策略,可在保证血糖控制得基础上进一步减少与治疗相关的体重增加、严重低血糖发生并进一步改与心血管相关的死亡风险。

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    2017-05-20 虈亣靌

    好东西大家一起学!

    0

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    2017-05-20 微笑人参

    这就是1+1大于2得效果,也许还要大于2

    0

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    2017-05-18 cqykthl

    实际上的患病人群远不止啊啊!

    0

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    2017-05-18 天涯183

    非常好的文章,很受启发,学习了

    0

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    2017-05-18 飛歌

    学习了很有用

    0

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CAN MED ASSOC J:户外环境温度可能影响妊娠糖尿病?

根据CMAJ(加拿大医学会杂志)发表的一项研究,室外空气温度与妊娠糖尿病的风险直接相关,每10℃的温度升高,糖尿病风险相对增加6%至9%。

BMJ Open:全国六省市万例糖尿病患者调查:1/3糖尿病患者存在视网膜病变

医三院的学者在全国六省市(山东、广西、广东、河南、内蒙古、吉林)的城市和农村的13473例糖尿病患者中开展的调查研究数据显示,糖尿病视网膜病变患病率为34.08%,威胁视力的糖尿病视网膜病变患病率为13.13%。

关于糖尿病的四个误解

世界卫生组织估计全球糖尿病患者为4.22亿。在1980至2014年间,糖尿病患者的数量几乎翻了一倍。尽管这种疾病非常普遍,但人们对它的误解也很多。以下是关于糖尿病的常见误解。1. 糖尿病是单纯的胰腺问题糖尿病的确会影响胰腺,但是它不仅仅会影响脖子以下的身体部分。如果我们采取这种观点,那么就会忽略患糖尿病导致的心理影响。这是一个大问题。由于糖尿病是一种长期的健康问题,所以糖尿病患者更容易产生抑郁问题

Diabetes Obes Metab:对于亚洲2型糖尿病患者 这种药物联合治疗安全有效

2017年5月,发表在《Diabetes Obes Metab》的一项由中国、韩国、马来西亚和英国科学家进行的研究,考察了亚洲2型糖尿病患者阿格列汀联合二甲双胍混合剂量联合治疗的有效性和安全性。

Diabetes Obes Metab:基线HbA1c水平和低血糖与不良心血管事件有多大关联?

2017年5月,发表在《Diabetes Obes Metab》的一项研究调查了糖化血红蛋白(HbA1c)与低血糖与主要不良心血管事件(MACE)风险之间的关联。研究结果显示,基线HbA1c水平或治疗1个月后HbA1c水平与MACE水平无关。低血糖事件和严重低血糖与MACE相关。

Diabetes Obes Metab:糖尿病合并高血压计步数带来的益处堪比吃药

近年来,计步数作为一种作追踪运动情况的工具非常流行。已经有研究结果支持将计步数融合到心血管代谢高风险个体的临床管理当中。2017年5月,发表在《Diabetes Obes Metab》的随机对照研究考察了医生处方计步和监测对2型糖尿病合并高血压患者的作用。