Changes in the Diagnosis and Management of Diabetes in Mexico City Between 1998-2004 and 2015-2019.
Changes in the Diagnosis and Management of Diabetes in Mexico City Between 1998-2004 and 2015-2019.
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DOI：
10.2337/dc20-2276
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发表时间：
2021-04
期刊：
影响因子：
16.2
通讯作者：
Tapia-Conyer R
中科院分区：
文献类型：
--
作者：
Aguilar-Ramirez D;Alegre-Díaz J;Gnatiuc L;Ramirez-Reyes R;Wade R;Hill M;Collins R;Peto R;Emberson JR;Herrington WG;Kuri-Morales P;Tapia-Conyer R
调查参加长期前瞻性研究的墨西哥成年人中糖尿病患病率、诊断和管理的趋势。从1998年到2004年，来自墨西哥城的159,755名成年人被招募到一项前瞻性研究中，从2015年到2019年，10,144名幸存者接受了重新调查。糖尿病的定义为自我诊断、使用降血糖药物或糖化血红蛋白≥6.5%。受控糖尿病定义为糖化血红蛋白7%。对年龄、性别和居民区的患病率估计统一标准化。COX模型探讨了控制和控制不充分的糖尿病与特定原因死亡率的相关性。在1998-2004年和2015-2019年，99623名和8986名参与者年龄在45岁到84岁之间。糖尿病患病率从1998-2004年的26%上升到2015-2019年的35%。在糖尿病患者中，先前诊断的比例从76%增加到89%，其中降糖药物的使用从80%增加到94%。糖尿病患者中HbA1c的中位数从8.2%下降到7.3%，而受控糖尿病参与者的比例从16%上升到37%。在先前诊断为糖尿病的患者中，降压药的使用率从35%增加到51%，降脂治疗的使用率从1%增加到14%。与糖尿病相关的过度死亡风险占35-74岁死亡人数的34%，其中5%可归因于控制不好的糖尿病，29%可归因于控制不充分的糖尿病。糖尿病控制不充分是墨西哥成年人过早死亡的主要原因。糖尿病管理的改善增加了诊断和控制，但仍有大量机会改善治疗，特别是通过降脂治疗。
To investigate the trends in diabetes prevalence, diagnosis, and management among Mexican adults who were participants in a long-term prospective study. From 1998 to 2004, 159,755 adults from Mexico City were recruited to a prospective study, and from 2015 to 2019, 10,144 survivors were resurveyed. Diabetes was defined as self-reported diagnosis, glucose-lowering medication use, or HbA1c ≥6.5%. Controlled diabetes was defined as HbA1c <7%. Prevalence estimates were uniformly standardized for age, sex, and residential district. Cox models explored the relevance of controlled and inadequately controlled diabetes to cause-specific mortality. During 1998–2004 and 2015–2019, 99,623 and 8,986 participants were aged 45–84 years. Diabetes prevalence had increased from 26% in 1998–2004 to 35% by 2015–2019. Of those with diabetes, the proportion previously diagnosed had increased from 76% to 89%, and glucose-lowering medication use among them had increased from 80% to 94%. Median HbA1c among those with diabetes had decreased from 8.2% to 7.3%, and the proportion of participants with controlled diabetes had increased from 16% to 37%. Use of blood pressure–lowering medication among those with previously diagnosed diabetes had increased from 35% to 51%, and their use of lipid-lowering therapy had increased from 1% to 14%. The excess mortality risk associated with diabetes accounted for 34% of deaths at ages 35–74 years, of which 5% were attributable to controlled and 29% to inadequately controlled diabetes. Inadequately controlled diabetes is a leading cause of premature adult death in Mexico. Improvements in diabetes management have increased diagnosis and control, but substantial opportunities remain to improve treatment, particularly with lipid-lowering therapy.
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影响因子：
7.7
作者：
Millard LAC;Davies NM;Gaunt TR;Davey Smith G;Tilling K
通讯作者：
Tilling K
DOI：
10.1016/s2213-8587(15)00316-2
发表时间：
2015-12
期刊：
The lancet. Diabetes & endocrinology
影响因子：
--
作者：
Pan A;Wang Y;Talaei M;Hu FB;Wu T
通讯作者：
Wu T
DOI：
10.1056/nejmsr1809937
发表时间：
2019-08-15
期刊：
The New England journal of medicine
影响因子：
--
作者：
All of Us Research Program Investigators;Denny JC;Rutter JL;Goldstein DB;Philippakis A;Smoller JW;Jenkins G;Dishman E
通讯作者：
Dishman E
影响因子：
9.2
作者：
Chang CC;Chow CC;Tellier LC;Vattikuti S;Purcell SM;Lee JJ
通讯作者：
Lee JJ
影响因子：
64.8
作者：
Bycroft C;Freeman C;Petkova D;Band G;Elliott LT;Sharp K;Motyer A;Vukcevic D;Delaneau O;O'Connell J;Cortes A;Welsh S;Young A;Effingham M;McVean G;Leslie S;Allen N;Donnelly P;Marchini J
通讯作者：
Marchini J