IGTandIFG：糖尿病前期.ppt

谢 谢！ 问题五 现时有足够的循证依据推荐针对IFG/IGT的干预措施吗？ 干预的必要性 糖尿病日益增加，长期并发症的严重性 延缓糖尿病发生需要治疗干预，也是复杂的 有效的干预有保护B细胞功能价值 存在延缓或预防微血管及心血管并发症的可能性 Diabetes Care 2007;30(3)L753-759 IFG/IGT干预的循证学依据 LSI=lifestyle intervention 生活方式干预降低糖尿病发病风险 药物干预降低糖尿病发病风险 IFG和IGT：糖尿病前期 ADA关于IGT和IFG干预的共识 Diabetes Care 2007;30(3)L753-759 23.0 M 36.2 M ↑57.0% 14.2 M 26.2 M ↑85% 48.4 M 58.6 M ↑21% 43.0 M 75.8 M ↑79% 7.1M 15.0 M ↑111% 39.3 M 81.6 M ↑108% M = million, AFR = Africa, NA = North America, EUR = Europe, SACA = South and Central America, EMME = Eastern Mediterranean and Middle East, SEA = South-East Asia, WP = Western Pacific Diabetes Atlas Committee. Diabetes Atlas 2nd Edition: IDF 2003. 糖尿病-日益严重的问题 World 2003 = 194 M 2025 = 333 M ↑ 72% AFR NA SACA EUR SEA WP 19.2 M 39.4 M ↑105% EMME 2003 2025 糖尿病-日益严重的问题 IDF: Diabetes Atlas Second Edition Executive Summary 全球10大糖尿病患病人数国家2003-2025年(20-79岁人群) IDF: Diabetes Atlas Second Edition Executive Summary 糖尿病视网膜病变 Leading cause of blindness in adults1,2 糖尿病肾病 Leading cause of end-stage renal disease3,4 心血管疾病 中风 2- to 4-fold increase in cardiovascular mortality and stroke5 糖尿病神经病变 Leading cause ofnon-traumatic lower extremity amputations7,8 8/10 individuals with diabetes die from CV events6 2型糖尿病的主要危害 1UK Prospective Diabetes Study Group. Diabetes Res 1990; 13:1–11. 2Fong DS, et al. Diabetes Care 2003; 26 (Suppl. 1):S99–S102. 3The Hypertension in Diabetes Study Group. J Hypertens 1993; 11:309–317. 4Molitch ME, et al. Diabetes Care 2003; 26 (Suppl. 1):S94–S98. 5Kannel WB, et al. Am Heart J 1990; 120:672–676.6Gray RP Yudkin JS. Cardiovascular disease in diabetes mellitus. In Textbook of Diabetes 2nd Edition, 1997. Blackwell Sciences. 7King’s Fund. Counting the cost. The real impact of non-insulin dependent diabetes. London: British Diabetic Association, 1996. 8Mayfield JA, et al. Diabetes Care 2003; 26 (Suppl. 1):S78–S79. 预防糖尿病的重要性 Source: All economic impact data are drawn from the Diabetes Atlas, third edition, International Diabetes Federation 200