Khalil H
Monash University, Monash Rural Health, Moe, Victoria, 3825, Australia.
Diabetes Metab Syndr. 2017 Nov;11 Suppl 1:S133-S139. doi: 10.1016/j.dsx.2016.12.022. Epub 2016 Dec 13.
The purpose of this study is to summarise the empirical evidence addressing diabetes microvascular complications and management. The effects of diabetes mellitus include long-term damage, dysfunction and failure of various organs. Microvascular disease tends to occur predominantly in tissues where glucose uptake is independent of insulin activity because these tissues are exposed to glucose levels that correlate very closely with blood glucose levels. These metabolic injuries cause altered blood flow and changes in endothelial permeability, extravascular protein deposition and coagulation resulting in organ dysfunction which in turn lead to microvascular complications.
A systematic search of the literature from 2000 to 2016 was conducted using four databases (Medline, Pubmed, Cochrane central and Google scholar) using search terms such as diabetic microvascular complications', pathogenesis, screening, risk factors, pharmacological and non-pharmacological interventions and management.
The current evidence supports a direct relationship between blood pressure (BP) and glycaemic control and progression of nephropathy and retinopathy. These are now considered as independent risk factors for microvascular disease progression. New fields of research addressing new drugs as potential therapeutic targets of the future will be presented.
The prevention of microvascular disease involves paying attention to aggravating risk factors and implementing screening programmes to improve early detection.
本研究的目的是总结关于糖尿病微血管并发症及管理的实证证据。糖尿病的影响包括各器官的长期损害、功能障碍和衰竭。微血管疾病往往主要发生在葡萄糖摄取独立于胰岛素活性的组织中，因为这些组织所接触的葡萄糖水平与血糖水平密切相关。这些代谢损伤会导致血流改变、内皮通透性变化、血管外蛋白质沉积和凝血，进而导致器官功能障碍，最终引发微血管并发症。
使用四个数据库（医学索引数据库、医学期刊数据库、考克兰系统评价数据库和谷歌学术），以“糖尿病微血管并发症”“发病机制”“筛查”“危险因素”“药物和非药物干预及管理”等为检索词，对2000年至2016年的文献进行系统检索。
目前的证据支持血压（BP）与血糖控制以及肾病和视网膜病变进展之间存在直接关系。现在这些被视为微血管疾病进展的独立危险因素。将介绍针对新药作为未来潜在治疗靶点的新研究领域。
微血管疾病的预防包括关注加重危险因素并实施筛查计划以改善早期检测。
