Gras C, Lecordier N, Spiegel A, Prigent D, Brodin S, Gendron Y
Médecin des Hôpitaux, Service de Médecine, Centre Hospitalier Territorial, Papeete, Tahiti.
Med Trop (Mars). 1992 Jan-Mar;52(1):35-42.
The authors report on the monitoring in the Diabetology Service of the Territorial Hospital Center of Papeete (French Polynesia) of 51 Polynesians, diabetics non insulin-dependent over periods of 12 to 30 months (average 26.5 months) from July 1988 to December 1991. 31 males and 20 females (sex-ratio 1.5). Mean age: 55.9 (extremes: 22 and 76 old years). Non insulin-dependent diabetes risk factors: heredity (43%), obesity (67%), new-born babies with a weight more than 4 kg (10%). Revealing factors of diabetes: systematic check-up (37%), clinical complications (36%), cardinal signs (20%). Recorded complications are: 1. microangiopathy: nephropathy (25%) including 7 renal insufficiency and 2 patients under dialysis; retinopathy (29%); 2. macroangiopathy: cardiovascular accident 1 case; angor 4 cases; obliterative arteritis of inferior limbs 5 cases; 3. neuropathy 9 cases (17%); 4. high arterial tension 55%; 5. metabolic complications (20%): 4 acidocetosis; 2 hyperosmolar coma; 4 severe hypoglycemia; 6. 16 diabetic feet (32%) among them 8 amputations; 7. 45 infectious complications in 27 patients are reviewed. Review of the complications according to diseases ancientness; before 10 years of evolution, each patient suffered of at least one complication, after 10 years, each patient got an average of 2 complications. Review of diabetic balance: 80% of the patients present a mean glycemia greater than 1.50; 54% present a postprandial glycemia greater than 2 gr. and 34% a A1 C Hb greater than 9%. The possible treatments are reviewed. During this monitoring, mortality was one case; 35 patients were admitted totaling 881 days of hospitalization.
作者报告了对法属波利尼西亚帕皮提地区医院中心糖尿病科51名波利尼西亚非胰岛素依赖型糖尿病患者的监测情况,监测时间为1988年7月至1991年12月,为期12至30个月(平均26.5个月)。其中男性31名,女性20名(性别比为1.5)。平均年龄55.9岁(年龄范围:22岁至76岁)。非胰岛素依赖型糖尿病的危险因素包括:遗传(43%)、肥胖(67%)、出生体重超过4千克(10%)。糖尿病的发现因素包括:系统检查(37%)、临床并发症(36%)、主要症状(20%)。记录的并发症有:1. 微血管病变:肾病(25%),其中7例肾功能不全,2例接受透析治疗;视网膜病变(29%);2. 大血管病变:心血管意外1例;心绞痛4例;下肢闭塞性动脉炎5例;3. 神经病变9例(17%);4. 高血压55%;5. 代谢并发症(20%):4例酮症酸中毒;2例高渗性昏迷;4例严重低血糖;6. 16例糖尿病足(32%),其中8例行截肢手术;7. 对27例患者的45例感染并发症进行了回顾。根据病程对并发症进行回顾:病程10年之前,每位患者至少患有一种并发症;病程10年之后,每位患者平均患2种并发症。对糖尿病病情进行回顾:80%的患者平均血糖大于1.50;54%的患者餐后血糖大于2克;34%的患者糖化血红蛋白大于9%。对可能的治疗方法进行了回顾。在此次监测期间,死亡1例;35例患者入院,总计住院881天。