New-onset diabetes after transplantation: 2003 International Consensus Guidelines
New-onset diabetes after transplantation: 2003 International Consensus Guidelines
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DOI：
10.1097/01.tp.0000069952.49242.3e
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发表时间：
2003-05-27
期刊：
影响因子：
6.2
通讯作者：
Wheeler, DC
中科院分区：
文献类型：
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作者：
Davidson, J;Wilkinson, A;Wheeler, DC
糖尿病是世界上最常见的慢性病之一，据估计，2000年全球糖尿病患病率超过1.76亿。此外，随着工业化社会变得老龄化、肥胖和久坐不动，这种疾病的流行率预计将在未来几年增加，预计到2030年将上升到3.7亿(1)。糖尿病的急性代谢并发症与高死亡率相关，尤其是高渗性高血糖(约15%)和酮症酸中毒(高达5%)。在这些情况下，老年患者和昏迷或低血压患者的预后更差(2)。在回顾流行病学和病理学证据之后，美国心脏协会也将糖尿病列为心血管疾病(CVD)的主要独立危险因素(3-8)。心血管疾病的表现包括动脉粥样硬化性冠心病(CHD)、心力衰竭(糖尿病心肌病)、心肌梗死、中风和外周血管疾病(7)。据报道，糖尿病患者中风的风险要高出两到四倍(7，9)。此外，患有心血管疾病的糖尿病患者的生存预后比患有心血管疾病但没有糖尿病的患者更差(8-11)。事实上，心血管疾病在大约65%的糖尿病患者中被列为死亡原因(12)。除了大血管并发症的风险外，糖尿病还与长期的微血管并发症有关，包括神经病变、视网膜病变、肾病和勃起功能障碍。在美国和欧洲，糖尿病肾病是终末期肾病最常见的单一原因(13)。关于视网膜病变，在患病20年后，几乎所有1型糖尿病患者和超过60%的2型糖尿病患者都有可能发展为失明的视网膜病变程度(14)。事实上，在发达国家，糖尿病现在被认为是导致失明的主要原因，每个国家都会导致12,000到24,000个新病例
Diabetes mellitus is 1one of the most common chronic diseases in the world, with an estimated worldwide prevalence of over 176 million in 2000. Furthermore, the prevalence of the disease is expected to increase in the coming years as industrialized societies become older, more obese, and more sedentary, and it is predicted to rise to 370 million by 2030 (1). Acute metabolic complications of diabetes are associated with high mortality rates; in particular, hyperosmolar hyperglycemia (approximately 15%) and ketoacidosis (up to 5%). The prognosis in these conditions is substantially worse in older patients and those with coma or hypotension (2). Following a review of epidemiologic and pathologic evidence, the American Heart Association has also classified diabetes a major independent risk factor for cardiovascular disease (CVD)(3–8). Manifestations of CVD include atherosclerotic coronary heart disease (CHD), heart failure (diabetic cardiomyopathy), myocardial infarction, stroke, and peripheral vascular disease (7). The risk for stroke has been reported to be two to four times higher in patients with diabetes (7, 9). Furthermore, patients with diabetes who develop CVD have a worse prognosis for survival than patients with CVD but without diabetes (8–11). In fact, CVD is listed as the cause of death in approximately 65% of patients with diabetes (12).In addition to the risk for macrovascular complications, diabetes is associated with long-term microvascular complications including neuropathy, retinopathy, nephropathy, and erectile dysfunction. Diabetic nephropathy is the most common single cause of end-stage renal disease in the United States and Europe (13). With respect to retinopathy, after 20 years with the condition, almost all individuals with type 1 diabetes and over 60% with type 2 diabetes have a degree of retinopathy that may progress to loss of vision (14). In fact, diabetes is now considered the leading cause of blindness in developed countries, causing 12,000 to 24,000 new cases each