Downs Charles A, Faulkner Melissa Spezia
Charles A Downs, Melissa Spezia Faulkner, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA 30322, United States.
World J Diabetes. 2015 May 15;6(4):554-65. doi: 10.4239/wjd.v6.i4.554.
Diabetes affects at least 382 million people worldwide and the incidence is expected to reach 592 million by 2035. The incidence of diabetes in youth is skyrocketing as evidenced by a 21% increase in type 1 diabetes and a 30.5% increase in type 2 diabetes in the United States between 2001 and 2009. The effects of toxic stress, the culmination of biological and environmental interactions, on the development of diabetes complications is gaining attention. Stress impacts the hypothalamus-pituitary-adrenal axis and contributes to inflammation, a key biological contributor to the pathogenesis of diabetes and its associated complications. This review provides an overview of common diabetic complications such as neuropathy, cognitive decline, depression, nephropathy and cardiovascular disease. The review also provides a discussion of the role of inflammation and stress in the development and progression of chronic complications of diabetes, associated symptomatology and importance of early identification of symptoms of depression, fatigue, exercise intolerance and pain.
糖尿病在全球影响着至少3.82亿人，预计到2035年这一数字将达到5.92亿。青少年糖尿病的发病率正在急剧上升，2001年至2009年间，美国1型糖尿病发病率上升了21%，2型糖尿病发病率上升了30.5%，这便是明证。有毒应激（生物与环境相互作用的结果）对糖尿病并发症发展的影响正日益受到关注。应激会影响下丘脑 - 垂体 - 肾上腺轴，并导致炎症，而炎症是糖尿病及其相关并发症发病机制的关键生物学因素。本综述概述了常见的糖尿病并发症，如神经病变、认知衰退、抑郁症、肾病和心血管疾病。该综述还讨论了炎症和应激在糖尿病慢性并发症的发生和发展中的作用、相关症状以及早期识别抑郁、疲劳、运动不耐受和疼痛症状的重要性。
