PREVENTION OF CARDIOVASCULAR DISEASE IN DIABETES MELLITU

预防糖尿病中的心血管疾病

• 批准号: 6191628
• 负责人: MARC THIBONNIER
• 金额: $ 62.65万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-30 至 2008-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6191628
• 关键词: antihyperlipoproteinemic agent; antihypertensive agents; blood glucose; blood lipid; blood pressure; cardiovascular disorder prevention; clinical research; combination chemotherapy; comorbidity; counseling; diabetes mellitus therapy; disease /disorder proneness /risk; health care cost /financing; human middle age (35-64); human old age (65+); human subject; human therapy evaluation; hypoglycemic agents; insulin sensitivity /resistance; longitudinal human study; noninsulin dependent diabetes mellitus; quality of life

Most diabetic patients die of cardiovascular disease (CVD), with CVD rates in diabetic persons two to four times those of the non-diabetic population. This increased CVD risk, along with the increasing prevalence of obesity and increasing numbers of elderly in the U.S. population, means that diabetes-associated CVD will become an even greater public health problem in the future. Diabetes mellitus is a complex metabolic disorder with generally evaluated levels of insulin resistance and variable levels of circulating insulin, which is often accompanied by abnormalities in carbohydrate, lipid, and protein metabolism and elevated blood pressure. While glucose control appears important for Type 2 patients, it is critical not to overlook treatment of associated CVD risk factor abnormalities. The effects on prevention of cardiovascular disease events of intensive control of established CVD risk factors (blood pressure and blood lipids), and intensive control of blood glucose, in Type 2 diabetes are unknown. The study is a multi-center randomized clinical trial of about 10,000 adult patients with Type 2 diabetes mellitus followed for four to seven years. The primary objective of this research program is to assess whether the rate of major cardiovascular disease events can be reduced by: (1) intensive control of blood sugar compared with conventional control; (2) intensive control of blood pressure compared with conventional control; and (3) intensive control of blood lipids compared with conventional control. Other objectives include the comparative cost effectiveness of the above interventions and their impact on health-related quality of life.

大多数糖尿病患者死于心血管疾病 (CVD)，糖尿病患者的 CVD 发生率是非糖尿病人群的两到四倍。 CVD风险的增加，加上美国人口中肥胖症患病率的增加和老年人数量的增加，意味着与糖尿病相关的CVD将在未来成为一个更大的公共卫生问题。糖尿病是一种复杂的代谢性疾病，通常评估胰岛素抵抗水平和循环胰岛素水平变化，通常伴有碳水化合物、脂质和蛋白质代谢异常以及血压升高。虽然血糖控制对于 2 型患者来说似乎很重要，但重要的是不要忽视相关 CVD 危险因素异常的治疗。在 2 型糖尿病中，强化控制已确定的 CVD 危险因素（血压和血脂）以及强化控制血糖对预防心血管疾病事件的效果尚不清楚。该研究是一项多中心随机临床试验，对约 10,000 名成年 2 型糖尿病患者进行了为期四到七年的随访。该研究计划的主要目标是评估是否可以通过以下方式降低主要心血管疾病事件的发生率：（1）与常规控制相比，加强血糖控制； (2)与常规控制相比，强化血压控制； (3)与常规控制相比，强化血脂控制。其他目标包括上述干预措施的相对成本效益及其对健康相关生活质量的影响。