Kostev Karel, Jockwig Achim, Hallwachs Alexander, Rathmann Wolfgang
IMS HEALTH, Frankfurt, Germany.
Fresenius University of Applied Sciences, Health & Social Faculty, Germany.
Prim Care Diabetes. 2014 Oct;8(3):250-5. doi: 10.1016/j.pcd.2014.01.011. Epub 2014 Feb 14.
To estimate the prevalence and risk factors of diabetic neuropathy in newly diagnosed type 2 diabetes in general practices.
Longitudinal data from nationwide general practices in Germany (n=630) and U.K. (n=100) (Disease Analyzer) were analyzed. Patients with newly diagnosed (<1 year) type 2 diabetes (2008-2012) were identified including 45,633 patients (age: 66, SD: 12 years) in Germany and 14,205 patients (age: 63, SD: 13 years) in U.K. Neuropathy was identified by ICD code (E11.4) or the original diagnosis. Associations of potential risk factors with neuropathy were investigated using logistic regression.
The prevalence of diagnosed neuropathy was 5.7% (95% CI: 5.5-5.9%) in Germany and 2.4% (1.9-2.9%) in U.K. In Germany, factors independently associated with neuropathy in stepwise logistic regression were age (>70 years: OR; 95% CI 2.1; 1.6-2.8), retinopathy (3.0; 2.1-4.2), peripheral artery disease (PAD: 1.9; 1.4-2.5), insulin treatment (4.6; 3.5-6.2) and oral antidiabetic drugs (OAD: 1.6; 1.2-2.0). In UK, male sex (1.4; 1.01-1.9), nephropathy (1.7; 1.2-2.5), PAD (1.5; 1.1-2.1), antihypertensives (1.7; 1.1-2.5), insulin (2.1; 1.1-3.8) and OAD (1.4; 1.01-1.8) were identified.
The prevalence of diabetic neuropathy at time of type 2 diabetes diagnosis was low in primary care (Germany, UK). Neuropathy was associated with age, PAD and microvacular complications.
评估在全科医疗中新诊断的2型糖尿病患者中糖尿病神经病变的患病率及危险因素。
分析来自德国（n = 630）和英国（n = 100）全国性全科医疗的纵向数据（疾病分析器）。确定新诊断（<1年）的2型糖尿病患者（2008 - 2012年），其中德国有45633例患者（年龄：66岁，标准差：12岁），英国有14205例患者（年龄：63岁，标准差：13岁）。通过国际疾病分类代码（E11.4）或原始诊断来确定神经病变。使用逻辑回归研究潜在危险因素与神经病变的关联。
德国确诊神经病变的患病率为5.7%（95%可信区间：5.5 - 5.9%），英国为2.4%（1.9 - 2.9%）。在德国，逐步逻辑回归中与神经病变独立相关的因素为年龄（>70岁：比值比；95%可信区间2.1；1.6 - 2.8）、视网膜病变（3.0；2.1 - 4.2）、外周动脉疾病（PAD：1.9；1.4 - 2.5）、胰岛素治疗（4.6；3.5 - 6.2）和口服降糖药（OAD：1.6；1.2 - 2.0）。在英国，确定的因素有男性（1.4；1.01 - 1.9）、肾病（1.7；1.2 - 2.5）、PAD（1.5；1.1 - 2.1）、抗高血压药（1.7；1.1 - 2.5）、胰岛素（2.1；1.1 - 3.8）和OAD（1.4；1.01 - 1.8）。
在初级保健机构（德国、英国）中，2型糖尿病诊断时糖尿病神经病变的患病率较低。神经病变与年龄、PAD及微血管并发症相关。
