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2型糖尿病患者症状与疾病严重程度、肥胖及血压的关联。

Association of symptoms of type 2 diabetic patients with severity of disease, obesity, and blood pressure.

作者信息

Bulpitt C J, Palmer A J, Battersby C, Fletcher A E

机构信息

Division of Geriatric Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, U.K.

出版信息

Diabetes Care. 1998 Jan;21(1):111-5. doi: 10.2337/diacare.21.1.111.

Abstract

OBJECTIVE

The symptoms of 430 type 2 diabetic patients were determined by a self-administered questionnaire before entry into the U.K. Prospective Diabetes Study.

RESEARCH DESIGN AND METHODS

Entry into the trial followed 2 months of dietary treatment for newly diagnosed patients with type 2 diabetes. Forty symptoms with five levels of severity were included in the questionnaire. A complaint rate was computed as the sum of symptom scores divided by the number of symptom questions answered.

RESULTS

The complaint rate was independently and positively related to BMI, fasting plasma glucose (FPG), and being a woman. Three symptoms--presence of dry mouth (P < 0.001), thirst (P < 0.01), and stomach pain (P = 0.02)--were related to FPG independent of sex, age, BMI, or blood pressure. Only dry mouth was related to HbA1c (P = 0.05). Complaints of shortness of breath, swollen ankles, headaches, heartburn, sweating, wheezing, nocturia, thirst, and diarrhea increased with BMI independently of other variables. A complaint of cold extremities decreased with BMI. Heartburn, weakness of limbs, and hot flushes were positively related to blood pressure, and unsteadiness was negatively related.

CONCLUSIONS

The symptoms reported by patients with type 2 diabetes increased with FPG and markedly with BMI. The symptoms associated with obesity have been underestimated in the past.

摘要

目的

在430例2型糖尿病患者进入英国前瞻性糖尿病研究之前,通过一份自填式问卷确定其症状。

研究设计与方法

新诊断的2型糖尿病患者在进入试验前接受了2个月的饮食治疗。问卷中包括40种症状,分为五个严重程度级别。将症状评分总和除以回答的症状问题数量计算出主诉率。

结果

主诉率与体重指数(BMI)、空腹血糖(FPG)以及女性性别呈独立正相关。三种症状——口干(P<0.001)、口渴(P<0.01)和胃痛(P=0.02)——与FPG相关,且不受性别、年龄、BMI或血压的影响。只有口干与糖化血红蛋白(HbA1c)相关(P=0.05)。呼吸急促、脚踝肿胀、头痛、烧心、出汗、喘息、夜尿、口渴和腹泻的主诉随BMI增加,且不受其他变量影响。四肢发冷的主诉随BMI降低。烧心、肢体无力和潮热与血压呈正相关,而步态不稳与之呈负相关。

结论

2型糖尿病患者报告的症状随FPG增加而增加,随BMI显著增加。过去肥胖相关症状被低估了。

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