Borch-Johnsen K, Kreiner S, Deckert T
Diabetes Res. 1986 Oct;3(8):397-400.
The aim of the study was to investigate the influence of diabetes care on the incidence and course of clinical nephropathy in patients with Type 1 (insulin-dependent) diabetes mellitus. After hospitalization at a diabetes care unit within 15 yr after diabetes onset, 246 patients were followed at the care unit, whereas 395 patients were non-attenders. The 2 groups were comparable with regard to age and calendar year at diagnosis, insulin dose and body weight. After 40 yr of diabetes duration the cumulative incidence of persistent proteinuria was significantly lower among patients treated at the unit (31.9% vs 44.8%, p less than 0.003). The median survival after onset of persistent proteinuria was significantly longer among patients followed at the diabetes care unit (p less than 0.003). Among patients not developing diabetic nephropathy, no difference in survival was found between the 2 groups, since 72% of the patients in each group survived 40 yr with Type 1 diabetes. It is concluded that patient care seems to be highly important for the incidence and the course of clinical nephropathy, whereas no such influence could be demonstrated in patients not developing clinical nephropathy.
本研究的目的是调查糖尿病护理对1型（胰岛素依赖型）糖尿病患者临床肾病的发病率和病程的影响。在糖尿病发病后15年内于糖尿病护理单元住院后，246例患者在该护理单元接受随访，而395例患者未接受护理。两组在诊断时的年龄、年份、胰岛素剂量和体重方面具有可比性。糖尿病病程40年后，在该护理单元接受治疗的患者中持续性蛋白尿的累积发病率显著较低（31.9%对44.8%，p<0.003）。在糖尿病护理单元接受随访的患者中，持续性蛋白尿发作后的中位生存期显著更长（p<0.003）。在未发生糖尿病肾病的患者中，两组之间未发现生存差异，因为每组中72%的患者在1型糖尿病状态下存活了40年。结论是，患者护理似乎对临床肾病的发病率和病程非常重要，而在未发生临床肾病的患者中未显示出此类影响。
