Daneman Denis
Division of Endocrinology, The Hospital for Sick Children and University of Toronto, 555 University Avenue, Toronto, Ontario M5P 1X8, Canada.
Horm Res. 2005;63(2):75-85. doi: 10.1159/000083692.
Micro- and macrovascular complications account for the major part of the morbidity and mortality associated with diabetes developing in childhood. Although advanced complications are exceptionally rare in the adolescent age group, it is during this phase that the progression of risk may accelerate. A number of potentially important factors have been identified which might contribute to risk of complication development: some provide insights into the genetics of these complications, while others are potentially modifiable, such as metabolic control, hypertension, smoking, obesity and hyperlipidemia. Recently, both consensus and evidence-based guidelines have been developed to guide those involved in the care of adolescents with diabetes in the prevention, screening and management of early diabetes-related complications in this vulnerable population. This article reviews the literature that underpins the available guidelines and stresses the pivotal role of excellent metabolic control in complication prevention.
微血管和大血管并发症是儿童期糖尿病相关发病和死亡的主要原因。虽然晚期并发症在青少年年龄组中极为罕见,但正是在这个阶段,风险进展可能加速。已经确定了一些可能导致并发症发生风险的潜在重要因素:一些因素有助于深入了解这些并发症的遗传学,而其他因素如代谢控制、高血压、吸烟、肥胖和高脂血症则可能是可改变的。最近,已经制定了共识和循证指南,以指导参与糖尿病青少年护理的人员对这一脆弱人群进行早期糖尿病相关并发症的预防、筛查和管理。本文回顾了支撑现有指南的文献,并强调了良好的代谢控制在并发症预防中的关键作用。