Klein R
Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison, USA.
Diabetes Care. 1995 Feb;18(2):258-68. doi: 10.2337/diacare.18.2.258.
In summary, over the past 16 years, since the publication of Kelly West's book, epidemiological study has provided better insight into the relation of hyperglycemia and diabetic complications. Data from the WESDR demonstrate a strong consistent relationship between hyperglycemia and the incidence and progression of microvascular (diabetic retinopathy, loss of vision, and nephropathy) and macrovascular (amputation and cardiovascular disease mortality) complications in people with IDDM and NIDDM (Figs. 19 and 20). The DCCT has demonstrated that intensive insulin therapy will reduce the incidence and progression of microvascular complications in people with IDDM (22). A number of further challenges await laboratory scientists and epidemiologists regarding hyperglycemia in people with diabetes. There is a need to understand the relation of hyperglycemia to pathogenetic mechanisms that lead to the development of specific complications, to develop new methods to detect and physiologically treat hyperglycemia, and to develop better methods of primary and secondary prevention of diabetic complications in people with IDDM and NIDDM.
总之，自凯利·韦斯特的书出版后的过去16年里，流行病学研究让我们对高血糖与糖尿病并发症之间的关系有了更深入的了解。威斯康星糖尿病视网膜病变流行病学研究（WESDR）的数据表明，在胰岛素依赖型糖尿病（IDDM）和非胰岛素依赖型糖尿病（NIDDM）患者中，高血糖与微血管并发症（糖尿病视网膜病变、视力丧失和肾病）以及大血管并发症（截肢和心血管疾病死亡率）的发生和进展之间存在着强烈且一致的关系（图19和图20）。糖尿病控制与并发症试验（DCCT）表明，强化胰岛素治疗将降低IDDM患者微血管并发症的发生率和进展（22）。关于糖尿病患者的高血糖问题，实验室科学家和流行病学家还面临许多进一步的挑战。有必要了解高血糖与导致特定并发症发生的致病机制之间的关系，开发检测和生理性治疗高血糖的新方法，以及开发更好的一级和二级预防IDDM和NIDDM患者糖尿病并发症的方法。
