Main Line Health System, Wynnewood, PA, USA; University of Pennsylvania, Philadelphia, PA, USA.
Medicine, Endocrinology, Diabetes and Bone Disease, Mount Sinai Hospital, New York, NY, USA.
Trends Endocrinol Metab. 2017 Sep;28(9):645-655. doi: 10.1016/j.tem.2017.05.005. Epub 2017 Jun 16.
Advances in understanding diabetes mellitus (DM) through basic and clinical research have helped clarify and reunify a disease state fragmented into numerous etiologies and subtypes. It is now understood that a common pathophysiology drives the diabetic state throughout its natural history and across its varied clinical presentations, a pathophysiology involving metabolic insults, oxidative damage, and vicious cycles that aggravate and intensify organ dysfunction and damage. This new understanding of the disease requires that we revisit existing diagnostics and treatment approaches, which were built upon outmoded assumptions. 'The Common Pathophysiologic Origins of Diabetes Mellitus and its Complications Construct' is presented as a more accurate, foundational, and translatable construct of DM that helps make sense of the hitherto ambiguous findings of long-term outcome studies.
通过基础和临床研究对糖尿病(DM)的深入了解,有助于阐明和统一将疾病状态碎片化的众多病因和亚型。现在已经清楚的是,一种共同的病理生理学贯穿于糖尿病的整个自然病史及其各种临床表现,这种病理生理学涉及代谢损伤、氧化损伤和恶性循环,这些都会加重和加剧器官功能障碍和损伤。对这种疾病的新认识要求我们重新审视现有的诊断和治疗方法,因为这些方法是建立在过时的假设基础上的。“糖尿病及其并发症的共同病理生理起源结构”被提出作为一种更准确、更基础、更具可转移性的 DM 结构,有助于理解长期预后研究中迄今仍不明确的发现。