Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Diabeteszentrum, Bad Oeynhausen.
Institut für Epidemiologie und medizinische Biometrie, ZIBMT, Universität Ulm, Ulm.
Diabet Med. 2020 Aug;37(8):1291-1298. doi: 10.1111/dme.13915. Epub 2019 Feb 27.
Comparing people with Type 2 diabetes mellitus with and without heart failure in terms of metabolic control, therapeutic regimen and comorbidities.
The Prospective Diabetes Registry (DPV) is a longitudinal documentation system for demographics, medical care and outcome in people with diabetes mellitus. It consists of follow-up data from people with diabetes mellitus who have agreed to be recorded in the registry. Clinical data are submitted by general practitioners, specialists and clinics throughout Germany and Austria. Some 289 954 people with Type 2 diabetes mellitus (years 2000 to 2015) were analysed using demographic statistics and adjustment for confounders based on linear and logistic regression analysis.
People with Type 2 diabetes mellitus (ICD code: E11) and heart failure (ICD code: I50) (N = 14 723) were older, more often women and presented with longer diabetes duration compared with those without heart failure. After adjustment for age, gender and diabetes duration, people with heart failure showed lower HbA , higher BMI and more intense insulin therapy. Analysis revealed that people with heart failure were more often treated with insulin, and more frequently received anti-hypertensives and lipid-lowering medication. They presented with lower systolic and diastolic BP. People with heart failure more frequently showed a history of comorbidities.
Heart failure is common in diabetes mellitus, but the prevalence in the DPV is lower frequent than expected. The reason for improved metabolic control in heart failure may be intensified therapy with insulin, lipid-lowering medication and anti-hypertensives in this cohort.
比较 2 型糖尿病伴心力衰竭与不伴心力衰竭患者的代谢控制、治疗方案和合并症情况。
前瞻性糖尿病登记处（DPV）是一个针对糖尿病患者的人口统计学、医疗保健和结局的纵向记录系统。它由同意在登记处记录的糖尿病患者的随访数据组成。临床数据由德国和奥地利的全科医生、专科医生和诊所提交。使用线性和逻辑回归分析基于人口统计学统计和混杂因素调整，分析了 289954 名 2 型糖尿病患者（2000 年至 2015 年）。
与无心力衰竭的患者相比，患有 2 型糖尿病（ICD 编码：E11）和心力衰竭（ICD 编码：I50）的患者年龄更大，女性更多，糖尿病病程更长。在调整年龄、性别和糖尿病病程后，心力衰竭患者的 HbA 更低，BMI 更高，胰岛素治疗强度更大。分析显示，心力衰竭患者更常接受胰岛素治疗，更常接受抗高血压药和降脂药物治疗。他们的收缩压和舒张压更低。心力衰竭患者更常患有合并症。
心力衰竭在糖尿病中很常见，但 DPV 中的患病率比预期的要低。心力衰竭患者代谢控制改善的原因可能是该队列中胰岛素、降脂药物和抗高血压药物的强化治疗。
