Bullard Kai McKeever, Cowie Catherine C, Lessem Sarah E, Saydah Sharon H, Menke Andy, Geiss Linda S, Orchard Trevor J, Rolka Deborah B, Imperatore Giuseppina
MMWR Morb Mortal Wkly Rep. 2018 Mar 30;67(12):359-361. doi: 10.15585/mmwr.mm6712a2.
Currently 23 million U.S. adults have been diagnosed with diabetes (1). The two most common forms of diabetes are type 1 and type 2. Type 1 diabetes results from the autoimmune destruction of the pancreas's beta cells, which produce insulin. Persons with type 1 diabetes require insulin for survival; insulin may be given as a daily shot or continuously with an insulin pump (2). Type 2 diabetes is mainly caused by a combination of insulin resistance and relative insulin deficiency (3). A small proportion of diabetes cases might be types other than type 1 or type 2, such as maturity-onset diabetes of the young or latent autoimmune diabetes in adults (3). Although the majority of prevalent cases of type 1 and type 2 diabetes are in adults, national data on the prevalence of type 1 and type 2 in the U.S. adult population are sparse, in part because of the previous difficulty in classifying diabetes by type in surveys (2,4,5). In 2016, supplemental questions to help distinguish diabetes type were added to the National Health Interview Survey (NHIS) (6). This study used NHIS data from 2016 to estimate the prevalence of diagnosed diabetes among adults by primary type. Overall, based on self-reported type and current insulin use, 0.55% of U.S. adults had diagnosed type 1 diabetes, representing 1.3 million adults; 8.6% had diagnosed type 2 diabetes, representing 21.0 million adults. Of all diagnosed cases, 5.8% were type 1 diabetes, and 90.9% were type 2 diabetes; the remaining 3.3% of cases were other types of diabetes. Understanding the prevalence of diagnosed diabetes by type is important for monitoring trends, planning public health responses, assessing the burden of disease for education and management programs, and prioritizing national plans for future type-specific health services.
目前,美国有2300万成年人被诊断患有糖尿病(1)。糖尿病最常见的两种类型是1型和2型。1型糖尿病是由于胰腺中产生胰岛素的β细胞受到自身免疫破坏所致。1型糖尿病患者需要胰岛素来维持生命;胰岛素可以每天注射,也可以通过胰岛素泵持续给药(2)。2型糖尿病主要是由胰岛素抵抗和相对胰岛素缺乏共同引起的(3)。一小部分糖尿病病例可能不是1型或2型,如青年发病的成年型糖尿病或成人隐匿性自身免疫性糖尿病(3)。尽管1型和2型糖尿病的大多数流行病例发生在成年人中,但美国成年人群中1型和2型糖尿病患病率的全国数据却很稀少,部分原因是以往在调查中难以按类型对糖尿病进行分类(2,4,5)。2016年,美国国家健康访谈调查(NHIS)增加了有助于区分糖尿病类型的补充问题(6)。本研究使用2016年NHIS的数据,按主要类型估计成年人中已诊断糖尿病的患病率。总体而言,根据自我报告的类型和当前胰岛素使用情况,0.55%的美国成年人被诊断患有1型糖尿病,即130万成年人;8.6%的人被诊断患有2型糖尿病,即2100万成年人。在所有已诊断病例中,5.8%为1型糖尿病,90.9%为2型糖尿病;其余3.3%的病例为其他类型的糖尿病。了解按类型划分的已诊断糖尿病患病率,对于监测趋势、规划公共卫生应对措施、评估教育和管理项目的疾病负担以及确定未来特定类型健康服务的国家计划优先级至关重要。