Ranjit Unnikrishnan I, Anjana R M, Mohan V
Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, Prevention and Control, IDF Centre of Education, Chennai-600 086.
J Assoc Physicians India. 2011 Apr;59 Suppl:8-12.
Most of the microvascular complications of diabetes are related to the degree and the length of exposure to hyperglycaemia. New data from the follow-up studies of the Diabetes Control and Complications Trial-the Epidemiology of Diabetes Intervention and Complications Study (DCCT-EDIC), and the United Kingdom Prospective Diabetes Study (UKPDS) emphasize the role of glycemic control early in the course of the disorder and its value in prevention of later complications. The phenomenon of ongoing beneficial effects on diabetic complications after a period of improved glycemic control even if followed by a return to usual (often poorer) metabolic control has been described as representing "metabolic memory" by the DCCT/EDIC investigators and as a "legacy effect" by the UKPDS investigators. This article reviews these concepts and explores the role of early use of insulin as a tool to achieve good glycemic control in type 2 diabetes.
糖尿病的大多数微血管并发症都与高血糖暴露的程度和时长有关。糖尿病控制与并发症试验——糖尿病干预与并发症流行病学研究（DCCT-EDIC）以及英国前瞻性糖尿病研究（UKPDS）随访研究的新数据强调了在疾病进程早期进行血糖控制的作用及其在预防后期并发症方面的价值。即使在一段时间的血糖控制改善之后又恢复到通常（往往较差）的代谢控制水平，对糖尿病并发症仍持续存在有益影响的现象，被DCCT/EDIC研究人员描述为“代谢记忆”，被UKPDS研究人员描述为“遗留效应”。本文回顾了这些概念，并探讨了早期使用胰岛素作为实现2型糖尿病良好血糖控制工具的作用。
