Trikkalinou Aikaterini, Papazafiropoulou Athanasia K, Melidonis Andreas
Aikaterini Trikkalinou, Athanasia K Papazafiropoulou, Andreas Melidonis, 1 Department of Internal Medicine and Diabetes Center, Tzaneio General Hospital of Piraeus, 18536 Piraeus, Greece.
World J Diabetes. 2017 Apr 15;8(4):120-129. doi: 10.4239/wjd.v8.i4.120.
It is true that a primary goal of diabetes early diagnosis and treatment is quality of life (QoL). The term QoL is still confusing but it is agreed that it composes of four components: The physical component, mental, cogitative component, psychological and social component. Many articles have been written addressing those four components. During the last five years 15500 articles and reviews have been written addressing diabetes and coronary arterial disease, 16100 addressing diabetes and renal function, 28900 addressing diabetes and retinopathy, 16800 addressing diabetic foot ulcers and other 26300 addressing diabetic neuropathy. Moreover 17200 articles are dealing with diabetic sexual dysfunction, 24500 with the correlation of diabetes and depression 17500 about diabetes and dementia, only 1 about diabetes and family functioning and 1950000 about diabetes and QoL, indicating the worldwide interest. In order to confront this metabolic anomaly and its consequences, researchers developed numerous generic and disease specific psychometric tools. With the aid of those psychometric tools the scientific community has started to realize the gruesome effect of diabetes on patients' lives. Diabetic's QoL becomes worse when complications start to develop or comorbidities coexist. Dominant amongst complications, in health-related quality of life (HRQoL) lowering, but not related to risk factors (genetic, the weight of birth, or others) is coronary arterial disease followed by renal failure, blindness, and the combination of micro- and macro-vascular complications and in some studies by sexual dysfunction. Moreover many are the comorbidities which deteriorate further the effect of diabetes in a patient life. Among them obesity, hypertension, dyslipidemia, depression, arthritis are the most common. Most intriguing field for research is the interaction of diabetes and depression and in some cases the progression to dementia. Many aspects and combinations of actions are under researchers' microscope regarding the improvement of HRQoL scores. Until now, the studies performed, have demonstrated little to moderate benefit. More of them are needed to draw safe conclusions on the topic of the best combination of actions to optimize the HRQoL scores.
糖尿病早期诊断和治疗的一个主要目标确实是生活质量(QoL)。生活质量这个术语仍然令人困惑,但人们一致认为它由四个部分组成:身体部分、精神和认知部分、心理和社会部分。已经有许多文章论述了这四个部分。在过去五年中,已经撰写了15500篇关于糖尿病和冠状动脉疾病的文章及综述,16100篇关于糖尿病和肾功能的文章,28900篇关于糖尿病和视网膜病变的文章,16800篇关于糖尿病足溃疡的文章,还有26300篇关于糖尿病神经病变的文章。此外,有17200篇文章探讨糖尿病性功能障碍,24500篇文章研究糖尿病与抑郁症的相关性,17500篇文章涉及糖尿病与痴呆症,仅有1篇文章关于糖尿病与家庭功能,还有1950000篇文章关于糖尿病与生活质量,这表明了全球范围内的关注。为了应对这种代谢异常及其后果,研究人员开发了许多通用的和针对特定疾病的心理测量工具。借助这些心理测量工具,科学界开始意识到糖尿病对患者生活产生的可怕影响。当并发症开始出现或合并症共存时,糖尿病患者的生活质量会变差。在并发症中,在降低健康相关生活质量(HRQoL)方面占主导地位,但与风险因素(遗传、出生体重或其他因素)无关的是冠状动脉疾病,其次是肾衰竭、失明以及微血管和大血管并发症的组合,在一些研究中还有性功能障碍。此外,许多合并症会进一步恶化糖尿病对患者生活的影响。其中肥胖、高血压、血脂异常、抑郁症、关节炎最为常见。最引人入胜的研究领域是糖尿病与抑郁症的相互作用,以及在某些情况下向痴呆症的进展。关于提高HRQoL分数,研究人员正在仔细研究许多方面和行动组合。到目前为止,所进行的研究显示出的益处很小到中等。需要更多的研究才能就优化HRQoL分数的最佳行动组合这一主题得出可靠的结论。