Druet Céline, Bourdel-Marchasson Isabelle, Weill Alain, Eschwege Eveline, Penfornis Alfred, Fosse Sandrine, Fournier Cécile, Chantry Michèle, Attali Claude, Lecomte Pierre, Simon Dominique, Poutignat Nathalie, Gautier Arnaud, Risse Mathilde, Fagot-Campagna Anne
Institut de veille sanitaire, 94415 Saint-Maurice, France.
Presse Med. 2013 May;42(5):830-8. doi: 10.1016/j.lpm.2013.02.312. Epub 2013 Apr 6.
Between 2001 and 2007, treatments for type 2 diabetes have increased and therapeutic choices have improved. However glycemic control remains insufficient. Cardiovascular risk control has widely increased. Statins, hypertensive and antithrombotic treatments are more often prescribed. Blood pressure and LDL cholesterol levels have decreased whatever age. However, progress remains possible, especially regarding blood pressure control. Obesity has increased between 2001 and 2007 to reach 41% whereas the frequency of dietetic visits has decreased. Insulin therapy (more than obesity) determines the frequency of dietetic visits: dietetic care happens too late. Important improvements of the quality of follow-up are observed. However, fundus exams and more specifically albuminuria measurement remain insufficiently performed and their progression is too slow, as well as the podiatric examination. Only 10% of people with type 2 diabetes have an endocrinology visit, which has been stable between 2001 and 2007. Information expectations of people with type 2 diabetes are strong, especially for diet. Education demand is lower but more important for people who have already benefited. This improvement of medical care leads to an increase in the cost of reimbursements. The consequences of diabetes, more than the disease itself, alter the quality of life.
在2001年至2007年期间，2型糖尿病的治疗方法有所增加，治疗选择也有所改善。然而，血糖控制仍不充分。心血管风险控制有了广泛提高。他汀类药物、高血压治疗药物和抗血栓治疗药物的处方更为常见。无论年龄大小，血压和低密度脂蛋白胆固醇水平均有所下降。然而，仍有进步的空间，尤其是在血压控制方面。2001年至2007年间，肥胖率上升至41%，而饮食咨询的频率却有所下降。胰岛素治疗（比肥胖问题更甚）决定了饮食咨询的频率：饮食护理开展得太晚。随访质量有了重要改善。然而，眼底检查，尤其是蛋白尿测量的执行情况仍然不足，其进展过于缓慢，足病检查亦是如此。只有10%的2型糖尿病患者接受了内分泌科就诊，这一比例在2001年至2007年间保持稳定。2型糖尿病患者的信息需求强烈，尤其是在饮食方面。教育需求较低，但对已经从中受益的人来说更为重要。医疗护理的这种改善导致报销费用增加。糖尿病的后果，而非疾病本身，会改变生活质量。
