Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Department of Medicine (Dermatology), University of Toronto, Toronto, Ontario, Canada.
Int J Dermatol. 2017 Dec;56(12):1319-1327. doi: 10.1111/ijd.13610. Epub 2017 Jun 26.
The association of specific skin disorders with diabetes mellitus (DM) has been well established. Current literature suggests that approximately 30-91% of patients with diabetes will experience at least one cutaneous manifestation of this systemic disease in their lifetime. To date, there are limited articles summarizing the link between necrobiosis lipoidica diabeticorum (NLD) prognosis and glycemic control in patients with diabetes. The objective of the study is to summarize and appraise the available evidence assessing the relationship between glycemic control and NLD. A literature search was conducted based on MEDLINE (1946-2015), EMBASE (1980-2015), Google Scholar, and PubMed for publications that described the results of diabetes control and NLD. Further studies were identified from bibliographies of all relevant studies, gray literature, and annual scientific assemblies. All studies investigating the relationship between DM (type 1 and type 2) management and NLD were included. Two reviewers independently extracted data including demographics, type of diabetes management measures (glucose, HbA1c, insulin), comorbidities, and outcome. A total of 622 studies were identified, and 10 studies met the inclusion and exclusion criteria: two case series and eight case reports. Of the 24 patients with NLD, 13 patients reported resolution of NLD after implementing various methods of glycemic control (diabetic diet consisting of 1600 kcal/day [1 patient], insulin regimen [3 patients], and pancreatic transplantation [9 patients]). Glycemic control may have a role in influencing the prognosis of necrobiosis lipoidica in patients with diabetes; however, there is currently insufficient evidence to support or refute this claim.
特定皮肤疾病与糖尿病（DM）的关联已得到充分证实。目前的文献表明，大约 30-91%的糖尿病患者在其一生中至少会出现一种这种全身性疾病的皮肤表现。迄今为止，很少有文章总结糖尿病患者的糖尿病性脂性渐进性坏死（NLD）预后与血糖控制之间的关系。本研究的目的是总结和评估评估血糖控制与 NLD 之间关系的现有证据。根据 MEDLINE（1946-2015）、EMBASE（1980-2015）、Google Scholar 和 PubMed 对描述糖尿病控制和 NLD 结果的文献进行了检索。从所有相关研究、灰色文献和年度科学大会的参考文献中进一步确定了其他研究。纳入了所有研究 NLD 与 DM（1 型和 2 型）管理之间关系的研究。两名审查员独立提取数据，包括人口统计学资料、糖尿病管理措施（血糖、HbA1c、胰岛素）、合并症和结果。共确定了 622 项研究，其中 10 项研究符合纳入和排除标准：两项病例系列和八项病例报告。在 24 例 NLD 患者中，13 例患者在实施各种血糖控制方法后 NLD 得到缓解（1 例患者采用 1600kcal/天的糖尿病饮食，3 例患者采用胰岛素治疗方案，9 例患者采用胰腺移植）。血糖控制可能对影响糖尿病患者的脂性渐进性坏死的预后有作用；然而，目前尚无充分的证据支持或反驳这一说法。
