Prevalence of diabetes complications in people with type 2 diabetes mellitus and its association with baseline characteristics in the multinational A1chieve study.
Prevalence of diabetes complications in people with type 2 diabetes mellitus and its association with baseline characteristics in the multinational A1chieve study.
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DOI：
10.1186/1758-5996-5-57
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发表时间：
2013-10-24
影响因子：
4.8
通讯作者：
Khamseh ME
中科院分区：
文献类型：
--
作者：
Litwak L;Goh SY;Hussein Z;Malek R;Prusty V;Khamseh ME
目前的国际糖尿病联合会指南建议HbA1c目标低于7.0%，但世界上许多糖尿病患者发现这一目标难以实现，从而增加了发生并发症的风险。本出版物探讨了参与A1chieve研究的2型糖尿病患者的糖尿病并发症患病率及其与基线特征的关系。A1chieve是一项为期24周的多国、开放标签、观察性研究，共有66726名2型糖尿病患者开始在常规临床护理中使用双相天冬氨酸胰岛素30、天冬氨酸胰岛素或地特米特胰岛素。参与者来自四大洲（亚洲、非洲、欧洲和南美洲）的28个国家。疾病特征的基线测量包括：糖化血红蛋白（HbA1c）、空腹（FPG）和餐后血糖（PPG）、高密度和低密度脂蛋白胆固醇（H-或LDL-C）、收缩压（SBP）和体重指数（BMI）。收集了并发症和血管疾病预防药物使用的数据。并发症发生率高（27.2%有大血管并发症，53.5%有微血管并发症），特别是在俄罗斯，血管疾病预防药物的使用低于预期。年龄、BMI、糖尿病病程、LDL-C、收缩压与大微血管并发症呈正相关，HDL-C与微血管并发症呈负相关（均p < 0.05）。HbA1c和FPG与大血管并发症呈负相关（均p < 0.05），这可能与横断面研究设计有关。这些结果表明，全世界都未能达到血糖目标。通过更早开始和优化胰岛素治疗方案（例如，在a1人群中使用胰岛素类似物）来更好地管理糖尿病，可能会减少血管并发症的发生率，改善糖尿病患者的生活，并减轻医疗保健系统的负担。
Current International Diabetes Federation guidelines recommend a target HbA1c <7.0%, but many people with diabetes worldwide find this difficult to achieve, increasing their risk of developing complications. This publication examines the prevalence of diabetes complications and its association with baseline characteristics in people with type 2 diabetes who participated in the A1chieve study. A1chieve was a 24-week, multinational, open-label, observational study of 66,726 people with type 2 diabetes who had begun using biphasic insulin aspart 30, insulin aspart, or insulin detemir in routine clinical care. Participants were enrolled from 28 countries across four continents (Asia, Africa, Europe and South America). Baseline measurements of disease characteristics included: glycated haemoglobin (HbA1c), fasting (FPG) and post-prandial plasma glucose (PPG), high- and low-density lipoprotein cholesterol (H- or LDL-C), systolic blood pressure (SBP), and body mass index (BMI). Data on complications and use of vascular disease preventative drugs were collected. Complication rates were high (27.2% had macrovascular complications and 53.5% had microvascular complications), particularly in Russia, and use of vascular disease preventative drugs was lower than expected. Age, BMI, diabetes duration, LDL-C, and SBP were positively associated, and HDL-C negatively associated, with macro- and microvascular complications (all p < 0.05). HbA1c and FPG were negatively associated with macrovascular complications (both p < 0.05), which may be linked to the cross-sectional study design. These results suggest a worldwide failure to achieve glycaemic targets. Better diabetes management with earlier initiation and optimisation of insulin regimens (e.g., with insulin analogues in the A1chieve population) may reduce the prevalence of vascular complications, improve the lives of people with diabetes and reduce the burden on healthcare systems.
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影响因子：
39.2
作者：
Saaddine, JB;Cadwell, B;Narayan, KMV
通讯作者：
Narayan, KMV
影响因子：
9.3
作者：
Hayashi T;Kawashima S;Nomura H;Itoh H;Watanabe H;Ohrui T;Yokote K;Sone H;Hattori Y;Yoshizumi M;Ina K;Kubota K;Japan Cholesterol and Diabetes Mellitus Investigation Group
通讯作者：
Japan Cholesterol and Diabetes Mellitus Investigation Group
影响因子：
5.8
作者：
Awa, Wendy L.;Fach, E.;Holl, R. W.
通讯作者：
Holl, R. W.
影响因子：
158.5
作者：
Holman, Rury R.;Paul, Sanjoy K.;Neil, H. Andrew W.
通讯作者：
Neil, H. Andrew W.
影响因子：
37.8
作者：
Toth, PP
通讯作者：
Toth, PP