Diabetes Research Unit, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, United Kingdom.
Curr Diab Rep. 2009 Dec;9(6):432-4. doi: 10.1007/s11892-009-0070-1.
Apart from tight blood glucose control, no other treatments have been shown to retard the progression of diabetic peripheral neuropathy (DPN). Therefore, identifying potential risk factors for DPN is important, particularly if they are modifiable. The Eurodiab baseline DPN study found a prevalence of 28% for DPN, with glycemic control and duration of diabetes being major determinants. It was also observed that a substantial proportion of those with good glucose control (hemoglobin A(1c) < 7%) were found to have DPN, which raised the possibility that other risk factors may be involved. Having excluded those with DPN at baseline, researchers followed 1172 type 1 diabetic subjects for 7.3 years (SD, 0.6) looking for risk factors for the development of DPN. DPN developed in 23.5% over the follow-up period; and apart from glycemic control and duration of diabetes, known to be important risk factors for DPN, traditional markers of macrovascular disease (eg, hypertension, smoking, obesity, and triglycerides) were found to be independent risk factors. The study was published in the New England Journal of Medicine and suggested that a need exists for clinical trials to confirm if modifying cardiovascular risk factors is an effective treatment for DPN.
除了严格的血糖控制，没有其他治疗方法被证明可以延缓糖尿病周围神经病变（DPN）的进展。因此，确定 DPN 的潜在风险因素很重要，特别是如果这些因素是可以改变的。Eurodiab 基线 DPN 研究发现，DPN 的患病率为 28%，血糖控制和糖尿病病程是主要决定因素。研究还观察到，相当一部分血糖控制良好（糖化血红蛋白 A1c<7%）的患者也患有 DPN，这表明可能存在其他风险因素。在排除基线时有 DPN 的患者后，研究人员对 1172 名 1 型糖尿病患者进行了 7.3 年（标准差为 0.6）的随访，以寻找 DPN 发展的风险因素。在随访期间，23.5%的患者出现 DPN；除了血糖控制和糖尿病病程这两个已知的 DPN 重要风险因素外，传统的大血管疾病标志物（如高血压、吸烟、肥胖和甘油三酯）也被发现是独立的风险因素。该研究发表在《新英格兰医学杂志》上，表明需要进行临床试验来确认是否可以通过改变心血管风险因素来有效治疗 DPN。
