Lepore G, Bruttomesso D, Nosari I, Tiengo A, Trevisan R
Diabetes Unit, A.O. Ospedali Riuniti, Bergamo, Italy.
Diabetes Nutr Metab. 2002 Aug;15(4):232-9.
The purpose of this cross-sectional study was to evaluate the degree of metabolic control, the prevalence of microvascular complications (nephropathy, retinopathy, and peripheral neuropathy) and their association with risk factors for cardiovascular diseases in all adult Type 1 diabetic out-patients attending 2 Diabetes Clinics of Northern Italy over 12 months. A total of 458 patients (mean age 37 +/- 12 yr, duration of diabetes 15.3 +/- 10.6 yr, BMI 23.2 +/- 3.1 kg/m2) were studied. Clinical characteristics and microvascular complications were evaluated. The proportion of patients with a good glycaemic control (HbA1c < 7%) was 14.7%. Nephropathy was observed in 24.4%, retinopathy in 41%, peripheral neuropathy in 23.7%. The prevalence of hypertension was 30.3%. Microvascular complications were associated with age, duration of diabetes, systolic blood pressure, creatinine, triglycerides and cholesterol plasma levels. Mean HbA1c was 8.5 +/- 1.6. Patients with HbA1c levels < 7% presented a lower prevalence of complications and lower levels of cholesterol, triglycerides, systolic blood pressure than patients with HbA1c > 9%. Our study indicates that an acceptable metabolic control is achieved in a too low proportion of Type 1 diabetic patients, even under multiple insulin injections. The association of poor metabolic control and microalbuminuria identifies a group of patients at higher risk of diabetic complications.
这项横断面研究的目的是评估在12个月期间，所有就诊于意大利北部2家糖尿病诊所的成年1型糖尿病门诊患者的代谢控制程度、微血管并发症（肾病、视网膜病变和周围神经病变）的患病率及其与心血管疾病危险因素的关联。共研究了458例患者（平均年龄37±12岁，糖尿病病程15.3±10.6年，体重指数23.2±3.1kg/m²）。评估了临床特征和微血管并发症。血糖控制良好（糖化血红蛋白<7%）的患者比例为14.7%。观察到肾病的患病率为24.4%，视网膜病变为41%，周围神经病变为23.7%。高血压患病率为30.3%。微血管并发症与年龄、糖尿病病程、收缩压、肌酐、甘油三酯和胆固醇血浆水平相关。平均糖化血红蛋白为8.5±1.6。糖化血红蛋白水平<7%的患者并发症患病率较低，胆固醇、甘油三酯和收缩压水平也低于糖化血红蛋白>9%的患者。我们的研究表明，即使在多次注射胰岛素的情况下，1型糖尿病患者中达到可接受代谢控制的比例也过低。代谢控制不佳与微量白蛋白尿的关联确定了一组糖尿病并发症风险较高的患者。
