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Diabetes Care：年轻1型糖尿病患者终末期肾病累积发病率降低

2018-10-24 xing.T MedSci原创

1型糖尿病终末期肾病累积发病率降低
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由此可见，在瑞典1型糖尿病患者人群中发生ESRD的风险仍然很低，而且似乎也随着时间的推移而有所降低。

糖尿病肾病是1型糖尿病的严重并发症。最近的研究表明，终末期肾病（ESRD）的发病率已经下降或者ESRD的发病已经推迟。近日，糖尿病领域权威杂志Diabetes Care上发表了一篇研究文章，研究人员分析了瑞典ESRD的发病率和时间变化趋势。

在这项研究中，研究人员纳入了病程>14年且糖尿病发病年龄为0-34岁的1型糖尿病患者。研究人员使用了三个国家糖尿病登记中心：瑞典儿童糖尿病登记中心、瑞典糖尿病发病率研究和国家糖尿病登记中心。瑞典肾脏登记处是瑞典全国肾脏替代治疗登记处，用于确定发生发展为ESRD的患者。

研究人员发现瑞典ESRD的累积发病率在糖尿病患病时间持续长达38年之后仍然很低（5.6％）。与1977-1984和1985-1990的发病率相比，1991-2001年期间1型糖尿病患者发生ESRD的发生率较低，且与糖尿病病程无关。

由此可见，在瑞典1型糖尿病患者人群中发生ESRD的风险仍然很低，而且似乎也随着时间的推移而有所降低。

原始出处：

Cecilia Toppe,et al. Decreasing Cumulative Incidence of End-Stage Renal Disease in Young Patients With Type 1 Diabetes in Sweden: A 38-Year Prospective Nationwide Study.Diabetes Care.2018.https://doi.org/10.2337/dc18-1276

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    2018-11-10 kord1982

    #累积发病率#

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    2018-11-20 ms9608593228839890

    #DIA#

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    2019-03-15 木头人513

    #Diabetes#

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channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37922, encryptionId=b2873e9220e, topicName=发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, createdName=lifestar, createdTime=Sun Mar 17 09:28:00 CST 2019, time=2019-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474614, encodeId=5a6614e46145d, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Thu Oct 25 23:28:00 CST 2018, time=2018-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1476370, encodeId=e83614e6370d0, content=<a href='/topic/show?id=eb69e81665d' target=_blank style='color:#2F92EE;'>#终末期肾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78166, encryptionId=eb69e81665d, topicName=终末期肾病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5fb27278676, createdName=zengjiayao, createdTime=Thu Oct 25 23:28:00 CST 2018, time=2018-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1693477, encodeId=cf1316934e759, content=<a href='/topic/show?id=7e2de81588c' target=_blank style='color:#2F92EE;'>#终末期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78158, encryptionId=7e2de81588c, topicName=终末期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1f6429431807, createdName=anminleiryan, createdTime=Thu Mar 07 05:28:00 CST 2019, time=2019-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1041942, encodeId=8aac1041942a3, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Wed Oct 24 11:28:00 CST 2018, time=2018-10-24, status=1, ipAttribution=)]
    2019-09-09 一叶知秋

    #1型糖尿病患者#

    0

  5. 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href='/topic/show?id=eb69e81665d' target=_blank style='color:#2F92EE;'>#终末期肾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78166, encryptionId=eb69e81665d, topicName=终末期肾病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5fb27278676, createdName=zengjiayao, createdTime=Thu Oct 25 23:28:00 CST 2018, time=2018-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1693477, encodeId=cf1316934e759, content=<a href='/topic/show?id=7e2de81588c' target=_blank style='color:#2F92EE;'>#终末期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78158, encryptionId=7e2de81588c, topicName=终末期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1f6429431807, createdName=anminleiryan, createdTime=Thu Mar 07 05:28:00 CST 2019, time=2019-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1041942, encodeId=8aac1041942a3, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Wed Oct 24 11:28:00 CST 2018, time=2018-10-24, status=1, ipAttribution=)]
    2018-11-30 ms5439512287675881

    #BET#

    0

  6. 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href='/topic/show?id=eb69e81665d' target=_blank style='color:#2F92EE;'>#终末期肾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78166, encryptionId=eb69e81665d, topicName=终末期肾病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5fb27278676, createdName=zengjiayao, createdTime=Thu Oct 25 23:28:00 CST 2018, time=2018-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1693477, encodeId=cf1316934e759, content=<a href='/topic/show?id=7e2de81588c' target=_blank style='color:#2F92EE;'>#终末期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78158, encryptionId=7e2de81588c, topicName=终末期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1f6429431807, createdName=anminleiryan, createdTime=Thu Mar 07 05:28:00 CST 2019, time=2019-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1041942, encodeId=8aac1041942a3, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Wed Oct 24 11:28:00 CST 2018, time=2018-10-24, status=1, ipAttribution=)]
    2019-03-17 lifestar

    #发病率#

    0

  7. 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href='/topic/show?id=eb69e81665d' target=_blank style='color:#2F92EE;'>#终末期肾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78166, encryptionId=eb69e81665d, topicName=终末期肾病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5fb27278676, createdName=zengjiayao, createdTime=Thu Oct 25 23:28:00 CST 2018, time=2018-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1693477, encodeId=cf1316934e759, content=<a href='/topic/show?id=7e2de81588c' target=_blank style='color:#2F92EE;'>#终末期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78158, encryptionId=7e2de81588c, topicName=终末期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1f6429431807, createdName=anminleiryan, createdTime=Thu Mar 07 05:28:00 CST 2019, time=2019-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1041942, encodeId=8aac1041942a3, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Wed Oct 24 11:28:00 CST 2018, time=2018-10-24, status=1, ipAttribution=)]
    2018-10-25 xue8604

    #糖尿病患者#

    0

  8. 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href='/topic/show?id=eb69e81665d' target=_blank style='color:#2F92EE;'>#终末期肾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78166, encryptionId=eb69e81665d, topicName=终末期肾病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5fb27278676, createdName=zengjiayao, createdTime=Thu Oct 25 23:28:00 CST 2018, time=2018-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1693477, encodeId=cf1316934e759, content=<a href='/topic/show?id=7e2de81588c' target=_blank style='color:#2F92EE;'>#终末期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78158, encryptionId=7e2de81588c, topicName=终末期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1f6429431807, createdName=anminleiryan, createdTime=Thu Mar 07 05:28:00 CST 2019, time=2019-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1041942, encodeId=8aac1041942a3, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Wed Oct 24 11:28:00 CST 2018, time=2018-10-24, status=1, ipAttribution=)]
    2018-10-25 zengjiayao

    #终末期肾病#

    0

  9. 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href='/topic/show?id=eb69e81665d' target=_blank style='color:#2F92EE;'>#终末期肾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78166, encryptionId=eb69e81665d, topicName=终末期肾病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5fb27278676, createdName=zengjiayao, createdTime=Thu Oct 25 23:28:00 CST 2018, time=2018-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1693477, encodeId=cf1316934e759, content=<a href='/topic/show?id=7e2de81588c' target=_blank style='color:#2F92EE;'>#终末期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78158, encryptionId=7e2de81588c, topicName=终末期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1f6429431807, createdName=anminleiryan, createdTime=Thu Mar 07 05:28:00 CST 2019, time=2019-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1041942, encodeId=8aac1041942a3, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Wed Oct 24 11:28:00 CST 2018, time=2018-10-24, status=1, ipAttribution=)]
    2019-03-07 anminleiryan

    #终末期#

    0

  10. 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time=2019-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1041942, encodeId=8aac1041942a3, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Wed Oct 24 11:28:00 CST 2018, time=2018-10-24, status=1, ipAttribution=)]
    2018-10-24 misszhang

    谢谢MedSci提供最新的资讯

    0

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Diabetic Med：对低血糖意识受损的1型糖尿病患者动态血糖监测和快速血糖监测的RCT研究结果

1型糖尿病患者血糖过低会导致发病和死亡，尤其是在低血糖意识障碍的情况下。目前，获得动态血糖监测（CGM）和快速葡萄糖监测技术的临床途径尚不清楚。近日，国际杂志 《Diabetic Med》上在线发表一项关于对低血糖意识受损的1型糖尿病患者动态血糖监测和快速血糖监测的RCT研究结果。研究人员评估了CGM和快速葡萄糖监测对1型糖尿病高风险人群的影响。 研究人员通过一项随机，非掩蔽的平行组研究。

Health Technol Assess：1型糖尿病儿童和青少年：持续皮下注射胰岛素vs每日多次注射

1型糖尿病长期并发症的风险与血糖控制相关，可使用强化胰岛素治疗方案降低该风险：每天多次注射（MDI；≥4次）和持续皮下注射胰岛素（CSII）。尽管缺乏证据显示更昂贵的CSII优于MDI，但是两种治疗方案都在NHS中广泛应用。2018年8月，发表在《Health Technol Assess》一项研究调查了1型糖尿病儿童和青少年CSII vs MDI的血糖控制情况、治疗的安全性、成本效果、患者的生活

Diabetes Care：1型糖尿病和精神病合并症儿童和青少年代谢控制不良

由此可见，1型糖尿病发病后2年内平均HbA1c水平较高可能表明后期会患精神病合并症。1型糖尿病的儿童和青少年的精神病合并症会增加不良代谢结局的风险。早期关注疾病负担可能会改善结局。

Neurology：创伤性脑损伤与1型糖尿病患者痴呆风险相关

由此可见，该研究表明中老年T1D患者罹患TBI后痴呆风险显著增加。鉴于患有T1D的个体的自我护理的复杂性以及使他们易于发生创伤和跌倒的合并症，未来的工作需要研究保护这个弱势群体的大脑健康的干预措施。