Happich M, Breitscheidel L, Meisinger C, Ulbig M, Falkenstein P, Benter U, Watkins J
Lilly Deutschland GmbH, Bad Homburg, Germany.
Curr Med Res Opin. 2007 Jun;23(6):1367-74. doi: 10.1185/030079907X188215. Epub 2007 May 21.
To obtain epidemiological data on the prevalence of predefined stages of diabetic microvascular complications from a representative cross-section of patients with existing microvascular complications of type 1 or type 2 diabetes in Germany.
A cross-sectional, retrospective study of medical records of 705 type 1 and 1910 type 2 adult diabetic patients with a diagnosis of retinopathy and/or peripheral neuropathy and/or nephropathy before 2002 and treated in 2002 in Germany.
Of 376 patients with type 1 diabetes having retinopathy, 59.3% had mild or moderate non-proliferative retinopathy without macular oedema, 27.1% had macular oedema, and 13.6% had severe retinopathy without macular oedema. In 862 patients with type 2 diabetes, the distribution of retinopathy/maculopathy classes was 56.8%, 35.5%, and 7.7%, respectively. Of 381 type 1 diabetes patients with observed peripheral neuropathy, 81.4% had sensorimotor neuropathy, 8.9% had diabetic foot conditions, and 9.7% had lower extremity amputations because of diabetes. In 1005 patients with type 2 diabetes, the distribution of neuropathy classes was 78.2%, 12.1%, and 9.7%, respectively. The proportions of patients with renal insufficiency in type 1 and type 2 diabetes groups were 15.3% versus 13.5%, respectively.
The study suggests that there are considerable proportions of patients with progressive stages of microvascular complications related to type 1 and type 2 diabetes in Germany. This underlines the importance of improvement of optimal quality of care and frequent screening for preventing late diabetic microvascular complications and the necessity of effective intervention strategies to tackle this major public health problem.
从德国1型或2型糖尿病微血管并发症患者的代表性横断面中获取关于糖尿病微血管并发症预定义阶段患病率的流行病学数据。
对705例1型成年糖尿病患者和1910例2型成年糖尿病患者的病历进行横断面回顾性研究,这些患者在2002年之前被诊断患有视网膜病变和/或周围神经病变和/或肾病,并于2002年在德国接受治疗。
在376例患有视网膜病变的1型糖尿病患者中,59.3%患有轻度或中度非增殖性视网膜病变且无黄斑水肿,27.1%患有黄斑水肿,13.6%患有重度视网膜病变且无黄斑水肿。在862例2型糖尿病患者中,视网膜病变/黄斑病变类别的分布分别为56.8%、35.5%和7.7%。在381例观察到周围神经病变的1型糖尿病患者中,81.4%患有感觉运动神经病变,8.9%患有糖尿病足病,9.7%因糖尿病进行了下肢截肢。在1005例2型糖尿病患者中,神经病变类别的分布分别为78.2%、12.1%和9.7%。1型和2型糖尿病组中肾功能不全患者的比例分别为15.3%和13.5%。
该研究表明,在德国,1型和2型糖尿病相关微血管并发症进展阶段的患者比例相当大。这凸显了改善最佳护理质量和频繁筛查以预防糖尿病微血管晚期并发症的重要性,以及采取有效干预策略应对这一重大公共卫生问题的必要性。