Department of Internal Medicine, Division of Endocrinology, American University of Beirut-Medical Center, Beirut, Lebanon.
Ann Transl Med. 2014 Dec;2(12):118. doi: 10.3978/j.issn.2305-5839.2014.09.03.
The paper entitled "Changes in diabetes-related complications in the United States, 1990-2010" published recently in the New England Journal of Medicine examined the spectrum of diabetes complications over the past 20 years based on a unique, nationally representative database in the Unites States. It was noted that although adults with diagnosis of diabetes have more than tripled between the years 1990 and 2010, the rates of all five major complications of diabetes have declined significantly with the greatest absolute declines being noted for acute myocardial infarction followed by stroke, lower-extremity amputation, end-stage renal disease and finally the death from hyperglycemic crisis. The greatest declines in most of the diabetes-related complications were observed among elderly persons who are above the age of 75 years with the exception of end stage renal disease which declined only in younger people but not among elderly. These findings could be due to the fact that over the past years there have been great advancements with regards to creating diabetes education programs especially after the publication of many trials that looked at the importance of intensive versus conventional glucose control, along with the enhanced management of other associated risk factors such as blood pressure, lipid levels, and smoking cessation.
这篇题为“1990 至 2010 年美国糖尿病相关并发症的变化”的论文最近发表在《新英格兰医学杂志》上,该研究基于美国独特的全国代表性数据库,考察了过去 20 年来糖尿病并发症的范围。研究指出,尽管在 1990 年至 2010 年间,被诊断患有糖尿病的成年人数量增加了两倍多,但五种主要糖尿病并发症的发生率均显著下降,其中急性心肌梗死的绝对降幅最大,其次是中风、下肢截肢、终末期肾病,最后是高血糖危象导致的死亡。在年龄超过 75 岁的老年人中,大多数与糖尿病相关的并发症的降幅最大,只有终末期肾病的降幅仅见于年轻人,而不在老年人中。这一发现可能是因为近年来在制定糖尿病教育计划方面取得了巨大进展,尤其是在许多研究强调强化与常规血糖控制的重要性之后,以及加强对其他相关危险因素(如血压、血脂水平和戒烟)的管理之后。