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年轻起病 2 型糖尿病患者的血糖控制特点及长期并发症。

Characteristics of Glycemic Control and Long-Term Complications in Patients with Young-Onset Type 2 Diabetes.

机构信息

Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine.

The Catholic University of Korea; 2Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea.

出版信息

Endocrinol Metab (Seoul). 2022 Aug;37(4):641-651. doi: 10.3803/EnM.2022.1501. Epub 2022 Aug 29.

Abstract

BACKGRUOUND

The prevalence of young-onset diabetes (YOD) has been increasing worldwide. As the incidence of YOD increases, it is necessary to determine the characteristics of YOD and the factors that influence its development and associated complications.

METHODS

In this retrospective study, we recruited patients who were diagnosed with type 2 diabetes mellitus between June 2001 and December 2021 at a tertiary hospital. The study population was categorized according to age: YOD (age <40 years), middle-age-onset diabetes (MOD, 40≤ age <65 years), and late-onset diabetes (LOD, age ≥65 years). We examined trends in glycemic control by analyzing fasting glucose levels during the first year in each age group. A Cox proportional-hazards model was used to determine the relative risk of developing complications according to glycemic control trends.

RESULTS

The fasting glucose level at the time of diagnosis was highest in the YOD group (YOD 149±65 mg/dL; MOD 143±54 mg/dL; and LOD 140±55 mg/dL; p=0.009). In the YOD group, glucose levels decreased at 3 months, but increased by 12 months. YOD patients and those with poor glycemic control in the first year were at a higher risk of developing complications, whereas the risk in patients with LOD was not statistically significant.

CONCLUSION

YOD patients had higher glucose levels at diagnosis, and their glycemic control was poorly maintained. As poor glycemic control can influence the development of complications, especially in young patients, intensive treatment is necessary for patients with YOD.

摘要

背景

全球范围内,青年发病型糖尿病(YOD)的患病率不断增加。随着 YOD 发病率的上升,有必要明确 YOD 的特征以及影响其发生发展和相关并发症的因素。

方法

本回顾性研究纳入了 2001 年 6 月至 2021 年 12 月在一家三级医院诊断为 2 型糖尿病的患者。根据年龄将研究人群分为青年发病型糖尿病(YOD,年龄<40 岁)、中年发病型糖尿病(MOD,40≤年龄<65 岁)和老年发病型糖尿病(LOD,年龄≥65 岁)。我们分析了各年龄组中患者在第一年的空腹血糖水平,以此来研究血糖控制的趋势。采用 Cox 比例风险模型,根据血糖控制趋势确定发生并发症的相对风险。

结果

YOD 组的诊断时空腹血糖水平最高(YOD 组为 149±65mg/dL;MOD 组为 143±54mg/dL;LOD 组为 140±55mg/dL;p=0.009)。YOD 组的血糖水平在 3 个月时下降,但在 12 个月时升高。YOD 患者和血糖控制不佳的患者在第一年发生并发症的风险较高,而 LOD 患者的风险则无统计学意义。

结论

YOD 患者在诊断时血糖水平较高,血糖控制难以维持。由于血糖控制不良可能影响并发症的发生,尤其是在年轻患者中,因此 YOD 患者需要强化治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f85b/9449113/f3cc4e03b326/enm-2022-1501f1.jpg

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