Gerich J E
Mayo Clin Proc. 1986 Oct;61(10):787-91. doi: 10.1016/s0025-6196(12)64818-6.
Diabetes mellitus is a heterogeneous disorder. About 80% of the patients with this disease are categorized as having non-insulin-dependent diabetes mellitus, a disorder resulting from varied degrees of insulin resistance and impaired insulin secretion; the causes for these abnormalities are unknown. The remaining 15 to 20% of patients have insulin-dependent diabetes mellitus, a disorder caused by the destruction of insulin-producing endocrine cells within the pancreas and currently considered to be the result of an autoimmune process. During the course of both types of diabetes mellitus, the so-called long-term complications of diabetes invariably occur to some extent in all patients. These complications include retinopathy, nephropathy, neuropathy, and premature atherosclerosis. The molecular basis for these complications is not completely understood, but recent evidence obtained from both experiments in animals and prospective clinical studies indicates that metabolic derangements associated with poor glycemic control are a major determinant of the frequency and severity of these complications. Such evidence is the rationale for current attempts to maintain near-normal glycemia in patients with diabetes mellitus.
糖尿病是一种异质性疾病。约80%的糖尿病患者被归类为非胰岛素依赖型糖尿病，该疾病由不同程度的胰岛素抵抗和胰岛素分泌受损所致；这些异常的病因尚不清楚。其余15%至20%的患者患有胰岛素依赖型糖尿病，这是一种由胰腺内产生胰岛素的内分泌细胞被破坏引起的疾病，目前认为是自身免疫过程的结果。在这两种类型的糖尿病病程中，所有患者在一定程度上都会不可避免地出现所谓的糖尿病长期并发症。这些并发症包括视网膜病变、肾病、神经病变和过早的动脉粥样硬化。这些并发症的分子基础尚未完全明了，但最近从动物实验和前瞻性临床研究中获得的证据表明，与血糖控制不佳相关的代谢紊乱是这些并发症发生频率和严重程度的主要决定因素。这些证据是目前试图使糖尿病患者维持接近正常血糖水平的理论依据。
