446例40—49岁人群膳食与糖尿病患病率的调查报告

目的 研究４４６例４０￣４９岁人群膳食与糖尿病患病率的关系。方法 随机对昆明城区４４６例４０￣４９岁人群的膳食与糖尿病（ＤＭ）和糖耐量低减（ＩＧＴ）患病率的关系进行调查。结果 该人群ＭＤ患者率为３．１４％,ＩＧＴ病率２．６９％。高档 其添加主要副食不同分为蔬菜、肥肉、糖食、豆类四组。各组平均年龄、工作强度、标准体重百分数均无显著性差异（Ｐ〈０．０５）。各组ＤＭ患病率：蔬菜组０,肥肉组８．９６％,糖     

高危人群中Ⅱ型糖尿病筛查

２４４０例Ⅱ型ＤＭ的高危人群筛选，并对新诊断的Ⅱ型ＤＭ及ＩＧＴ随访６月。结果：ＤＭ及ＩＧＴ患病率分别为５０．５％及９．４％。与正常组比有显差异。且随年龄递增，高峰在５０￣７０岁组。体重指数〉２５ＤＭ及ＩＧＴ患病率分别为５０．５％及９．４％。高血压、高血压脂、阳性家族史，二患病率均超过正常组。提示年龄、体重、血压、血脂、家族史是Ⅱ型ＤＭ的危险因子。     

我国东北一个县自然人群糖尿病流行病学调查

按照ＷＨＯ和中华医学会糖尿病学会规定的标准，１９９３年我们对吉林省柳河县进行了糖尿病流行病学调查，发现糖尿病（ＤＭ）及糖耐量低减（ＩＧＴ）的患病率已分别达到４．５２％和２．５３％。城镇ＤＭ患病率（５．３８％）略高于农村（２．３４％）。ＤＭ及ＩＧＴ患病率均随年龄增加而增高。ＩＧＴ患病率与标准体重百分比呈正相关关系，ＩＧＴ组平均标准体重百分数为１１３．６±２３．７％，显著高于对照组（Ｐ＜０．０２）。肥胖组ＩＧＴ患病率高达８．２９％，与非肥胖组（２．４０％）相比亦有增高的趋势。无论男性还是女性，ＤＭ和ＩＧＴ患者的腰／臀比值均显著高于对照组（Ｐ＜０．００１）。ＤＭ和ＩＧＴ患者的血压也明显高于对照组（Ｐ＜０．００１）。按体力劳动强度分组分析，随劳动强度的增加，ＤＭ患病率有减少的趋势。上述结果表明，该县糖耐量异常的比例已达很高的水平，这种情况可能与当地饮食习惯不良、体力劳动过少、腹部型肥胖者比例较大等因素有关。     

北京地区20682人群糖尿病筛查及1566人OGTT的研究

为积极开展对糖尿病的防治，我们在１９９４年北京地区年龄≥２５岁、城市农村各半的２０６８２人群进行标准馒头餐试验，以馒头餐后２小时血糖≥６．７ｍｍｏｌ／Ｌ者１５６６人施以ＯＧＴＴ、胰岛素、血脂、尿白蛋白及血压（ＢＰ）、ＥＣＧ检查。结果表明：北京地区糖尿病（ＤＭ）患病率为３．４４％，比１９８０年增高４．８倍，糖耐量减低（ＩＧＴ）患病率为３．２６％，北京近郊和远郊农村ＤＭ和ＩＧＴ患病率都明显高于城区（Ｐ＜０．００１）。ＢＭＩ≥２５和ＢＰ＞１８．７／１２．０ｋＰａ（１４０／９０ｍｍＨｇ）者ＤＭ和ＩＧＴ的患病率明显高于ＢＭＩ＜２５和ＢＰ≤１８．７／１２．０ｋＰａ者，患病率随年龄增加呈等倍级数递增。本次调查而诊断的ＤＭ组中，已并发冠心病者占２６．９６％，并发早期糖尿病肾病者占３２．８％。     

非胰岛素依赖型糖尿病和糖耐量低减患病情况研究

我们于１９９４年７月－１９９５年３月对湖北省部分地区２５岁及以上的９４５０名居民进行了非胰岛素依赖型糖尿病与糖耐量低减患病率的抽样调查。结果表明：ＮＩＤＤＭ患病率为２．６２％，ＩＧＴ患病率４．４８％，男女性的ＮＩＤＤＭ与ＩＧＴ患病率差异无显著性，城乡ＮＩＤＤＭ，ＩＧＴ患病率差异有显著性，ＮＩＤＤＭ和ＩＧＴ的患病率均随着年龄升高而升高。     

江苏省社区老年人群糖尿病流行特点的研究

目的探讨江苏省老年人群糖尿病（ＤＭ）的流行特征及影响因素。方法按分层整群抽样原则，共抽取江苏省城乡八层样本计１６３６人，按照ＷＨＯ的诊断标准进行调查。结果该省６０岁以上社区老年人群ＤＭ、糖耐量减低（ＩＧＴ）的粗患病率分别为１４４９％和１０２１％，已达到一个比较高的水平；ＤＭ和ＩＧＴ患病率随体质量指数（ＢＭＩ）的增大而增高、职业性体力活动强度的增加而降低；ＤＭ家族史阳性者患病率显著高于阴性者，城镇高于乡村，女性高于男性。结论该省老年人群ＤＭ的患病率已达到较高水平，加强老年人群ＤＭ的预防和控制，已成为该省卫生工作的一项紧迫任务。     

中国东部原黑热病流行区人群免疫学监测

１９８９￣１９９６年，用ＬＤＴ和ＩＦＡＴ对山东（１３个市）、江苏（４个市）和安徽（３个县）３省原黑热病流行区人群进行免疫学监测。１９８９￣１９９０年，山东省３０岁以下人群ＬＤＴ无１例阳性，３０岁以上人群阳性率平均为４．４％。１９９１￣１９９２年，江苏省１０岁以下人群有ＬＤＴ阳性者，但３０岁以下和以上人群ＬＤＴ阳性率有显著差异（Ｐ〈０．０１）。１９９６年对江苏省人群进行动态监测，１０岁以下人群已无Ｌ     

福建省16157人口中糖尿病调查报告

１９９５年福建省六市１６１５７人口中糖尿病（ＤＭ）患病率调查表明：ＤＭ及糖耐量异常（ＩＧＴ）分别为２４９％及２２９％，前者比１９７９年明显增高，莆田和福州地区增高尤为显著，而宁德、武夷山、厦门则较低，造成这种差异的原因可能是莆田、福州地区热量摄取多，生活水平及超重比例均明显高于宁德和武夷山，厦门虽为特区，但受检对象生活水平低。ＤＭ及ＩＧＴ患病率随年龄增高而增高。肥胖尤其腰臀比值增高者其发病率亦高。说明老龄化趋势、体力活动少和热量摄取过多导致的肥胖是造成ＤＭ及ＩＧＴ患病率快速增加的主要原因     

1994年中国糖尿病患病率及其危险因素

为调查全国糖尿病及糖耐量低减（ＩＧＴ）的患病率及糖尿病危险因素，对全国１９省市年龄≥２５岁的２２４２５１人群进行横向普查，根据１９８５年ＷＨＯ标准，年龄在２５～６４岁的２１３５１５人群中，糖尿病患病率为２．５１％，糖耐量低减患病率为３．２０％（按１９９０年全国人口年龄标化后患病率）；新诊断糖尿病的比例（７０．３３％）明显高于已确诊的糖尿病者。现患病率是１０年前的３．０倍左右，其中农村患病率的增长高于城市。经多因素ｌｏｇｉｓｔｉｃ逐步回归分析显示，年龄、体重指数或腰臀围比、糖尿病家族史、高血压、低体力活动、高收入为非胰岛素依赖型糖尿病（ＮＩＤＤＭ）的独立危险因素，而且在高收入人群中，低文化程度也为ＮＩＤＤＭ的独立危险因素。     

陈旧性心肌梗塞患者糖代谢及相关因素的调查分析

追踪调查了２２４例陈旧性心肌梗塞患者的糖代谢状况，分析该人群糖耐量异常与冠心病发病危险因素的联系。２２４例中，符合ＮＩＤＤＭ诊断者５２例，符合ＩＧＴ诊断者５４例，计高血糖占４７．３％。与同期同社区３万普通人群成年糖尿病调查结果比较，分别是其５０－５９岁及≥６０岁同年龄组ＮＩＤＤＭ患病率的２．７及３．２倍，ＩＧＴ患病率的３．４及３．７倍。显示了心肌梗塞与糖代谢异常二者间的密切联系。     

蚌埠市区第三次2型糖尿病患病现状调查

整群随机抽样调查蚌埠市区25-75岁常住居民3073人,发现人群中2型糖尿病、总糖耐量减低患病率呈快速增长趋势,2型糖尿病的发病趋于年轻化。肥胖高血压人群2型糖尿病、糖调节受损患病率明显高于正常人群。应注重早期2型糖尿病筛查。     

The burden of diabetes and impaired glucose tolerance in India using the WHO 1999 criteria: prevalence of diabetes in India study (PODIS)

This random multistage cross-sectional population survey was undertaken to determine the prevalence of diabetes mellitus (DM) and impaired glucose tolerance (IGT) in subjects aged 25 years and above in India. The study was carried out in 77 centers (40 urban and 37 rural). 18363 (9008 males and 9355 females) subjects were studied. 10617 (5379 males and 5238 females) were from urban areas and 7746 (3629 males and 4117 females) from rural areas. Blood samples were taken after a fast of 10-12 h and 2 h after 75 g of oral glucose. Subjects were categorized as having IGT or DM using the World Health Organisation (WHO) (1999) criteria. The standardized prevalence rate for DM in the total Indian, urban and rural populations was 4.3, 5.9 and 2.7%, respectively. The corresponding IGT rates in the three populations was 5.2, 6.3 and 3.7%, respectively. The urban prevalence of DM and IGT was significantly greater than in the rural population (P < 0.001 in both instances). The prevalence of DM was significantly, more than that of IGT (P < 0.001) within both the rural and urban populations. Type 2 diabetes is a major health problem is India.     

Epidemiology of Diabetes Mellitus in the Elderly in Northern Greece: a Population Study

This population based study was undertaken to ascertain the overall prevalence of diabetes mellitus (DM) and impaired glucose tolerance (IGT) in the elderly using the WHO criteria. The role of obesity in the development of DM or IGT has been investigated for both sexes per decade of age. Furthermore the potential for DM to increase with age, as has been suggested before, has been evaluated using the IGT as a proportion of total glucose intolerance (IGT/TGI) for the same parts of the tested sample. From the 647 persons registered as elderly people in a small town in northern Greece (total population 5875 people), 66 persons did not participate in this survey. Fifty-six subjects (9.7%) had previously diagnosed DM. The remainder were tested using fasting blood glucose measurements or an oral glucose tolerance test (OGTT). The prevalence of previously undiagnosed DM according to fasting blood glucose values or after 2 h of 75 g load values was 10.1% and 9.3%, respectively. Thus the overall prevalence of DM was 29.1% and of IGT was 15.1%. These data support an increased frequency of DM (65% previously undiagnosed) and IGT in the elderly, whereas this population's susceptibility seems to decline in the older groups for both sexes. Obesity remains a risk factor for DM and IGT particularly among the younger groups although its role has been found to decline with age.     

Epidemiologic study of type 2 diabetes in Taiwan

Diabetes mellitus (DM) in adults is a global health problem, although its prevalence varies widely between different populations and the rate has generally increased worldwide. In Taiwan, the mortality rate from DM has almost doubled over the past 10 years. The prevalence of DM in Taiwan was established between 1985 and 1996 and the rates were between 4.9 and 9.2%. The prevalence of impaired glucose tolerance (IGT) was 15.5% (men 15% and women 15.9%). The prevalence of DM and IGT increased significantly with age for both genders. The significant factors associated with newly diagnosed DM were age, BMI, family history of DM, systolic blood pressure (hypertension), physical activity and serum triglyceride levels. The prevalence of large vessel disease (LVD) in DM and non-diabetic subjects were 20.0 and 12.9%, respectively. Among diabetics, 15.8% had ischemic heart disease (IHD), 1.7% leg vessel disease (leg VD), and 2.5% stroke. In non-diabetics, the prevalence of the aforementioned macroangiopathies were 11.5, 0.2 and 1.2%, respectively. The diabetics had a significantly higher prevalence of macrovascular disease than non-diabetic subjects. The most significantly associated with the LVD was serum cholesterol levels. Serum cholesterol and HbA1(c) were significantly associated with the development of IHD. Cigarette smoking and female gender were significantly associated with the leg VD. The prevalence of diabetic retinopathy (DR) was 35.0%. (background DR 30%, preproliferative DR 2.8% and proliferative DR 2.2%, respectively.) The prevalence of DR for previously and newly diagnosed diabetics were 45.2 and 28.3% (men 42.8 vs. 33.3% and women 47.5 vs. 24.8%), respectively. From multiple logistic regression analysis, duration of DM was the most important risk factor related to DR. Diabetic subjects treated with insulin had a higher risk of developing retinopathy than those treated with dietary control. The prevalence of nephropathy and neuropathy were 12.9 and 23.5%, respectively. For those patients with and those without nephropathy and neuropathy, the duration of DM, percentage of insulin treatment, percentage of hypertension, and fasting plasma glucose were significantly different. Diabetic duration, hypertension, insulin treatment and glycemic control consistently correlated with nephropathy and neuropathy. In conclusion, the prevalence of DM in Taiwan was between 4.9 and 9.2%, and the prevalence of IGT was 15.5%. The possible risk factors of newly diagnosed diabetes were age, family history of DM, BMI, SBP (hypertension), physical activity and triglyceride levels. Diabetes in Chinese subjects share many characteristics similar to other Asian populations. The burden imposed by the chronic complications of diabetes is massive. In Taiwan, the mortality rates from DM have increased greatly over the past 10 years. Reduction of the modificable risk factors such as BMI, hypertenion and dyslipidemia, and increase of physical activity and good glycemic control through public health efforts may help to reduce the risk of DM and its chronic complications.     

Increasing incidence of abnormal glucose tolerance in women with prior abnormal glucose tolerance during pregnancy: DIAGEST 2 study

Aims Mild blood glucose abnormalities during pregnancy may be linked to later glucose tolerance abnormalities or diabetes mellitus. Our aim was to determine the prevalence of diabetes mellitus (DM), impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) 6.75 years after delivery in women with differential blood glucose status during pregnancy. Methods We compared long‐term outcomes among control women (n = 221), women with abnormal glucose tolerance during pregnancy (AGT; n = 322) and women with gestational diabetes (GDM; n = 466) who participated in DIAGEST 1. Women were recruited from 15 public maternity units in France. Clinical parameters could be determined in 155 control, 220 AGT and 338 GDM subjects. Rates of DM, IGT, IFG and ‘Any Abnormality’ were compared between the groups (American Diabetes Association criteria). Results Adherence to follow‐up was 70.7%. Rates of DM, IGT and IFG were respectively 0.9% DM, 2.1% IGT and 3.6% IFG in the control group; rates in the AGT group were 6.3%, 11.3% and 6.3%. In GDM women, the rates of DM, IGT and IFG were, respectively, 18.0%, 13.4% and 8.5%. Predictors for DM were previous GDM, medical history of hypertension, age at delivery ≥ 33 years, family history of diabetes, fasting glucose during pregnancy ≥ 5.5 mmol/l and the severity of hyperglycaemia during pregnancy defined by the number of abnormal blood glucose values fasting, 1, 2 and 3 h during the glucose tolerance test at diagnosis of GDM. Conclusion This study has identified a high prevalence of glucose tolerance abnormalities after AGT during pregnancy. Compared with GDM women, women with AGT have an intermediate risk of later diabetes.     

河南省涂阳肺结核合并糖尿病情况调查分析

目的了解河南省涂阳肺结核合并糖尿病流行情况、X线特点、耐药情况与治疗转归,以供肺结核临床诊治和控制工作参考。方法在第二轮结核病耐药监测时同步进行血糖检测。所入选的涂阳肺结核病人在抗结核治疗前空腹服用葡萄糖75g后2h抽静脉血查血糖。胸部X线片特征由专家读片组共同读片分析并记录。结果调查入选902例涂阳肺结核病人,糖尿病患者检出率为12.6%,糖耐量降低者检出率为14.9%,二者合计为27.5%;40岁以上年龄组检出率显著高于40岁以下年龄组。合并糖尿病的涂阳肺结核耐药率为45.6%,显著高于血糖正常组(35.2%)及糖耐量降低组(32.8%)(P<0.05);血糖异常的肺结核病人病灶分布于中下肺野及对侧、双侧播散者较多,渗出性病灶、干酪性病灶、合并胸腔积液在肺结核合并糖尿病的病人中较血糖正常者多(分别为93%,87.7%、14.0%)。血糖异常涂阳肺结核空洞发生率较高(95.9%)。强化期痰菌转阴率、疗程结束治愈率血糖正常组分别为88.1%、91.7%,血糖异常组分别为77.4%、86.3%,(P<0.05)。结论糖尿病及糖耐量异常者在涂阳肺结核病人中的检出率明显高于一般人群;涂阳肺结核者合并糖尿病者X线表现有一定特点,有助于及时发现,诊治;在涂阳肺结核病合并糖尿病、糖耐量降低者中,血糖异常知晓率较低;并糖尿病的复治涂阳肺结核耐药率高,血糖异常可影响痰菌及时阴转和治愈率,不利于结核病流行的控制,值得重视。     

Prevalence of known and undetected diabetes and associated risk factors in central Kerala--ADEPS

Amrita Diabetes and Endocrine Population Survey (ADEPS) was conducted as a community-based cross-sectional survey to assess the prevalence of undetected diabetes mellitus (DM) and impaired glucose tolerance (IGT) and their possible relationship with various risk factors in an urban South Indian population. An initial house-to-house survey of adults between ages 18 and 80 years (n = 3069) was followed by a second phase consisting of health check-up and biochemical evaluations of participants (n = 986). DM and IGT were diagnosed as per WHO criteria. Reported prevalence of known diabetes mellitus in the survey was 9.0% (276/3069); (M-8.7% and F-9.2%). Among the screened subjects who underwent blood testing, the prevalence of newly diagnosed diabetes was 10.5%. The prevalence of IGT was 4.1% and IFG was 7.1%. Increasing age, obesity, positive family history of diabetes, abnormal subscapular triceps skin fold ratio and presence of acanthosis nigricans (AN) were all found to be associated with increased risk of DM. The finding of high prevalence of newly detected DM and IGT in this population of Kerala with the highest standards of health care and literacy level compared to other states of India, emphasizes the need for routine screening of high-risk groups for early detection of the disease. A simple cutaneous sign, acanthosis nigricans was independently associated with increased risk of type 2 diabetes in this survey and can be used as indication for screening for DM and IGT.     

Comparing the ADA 1997 and the WHO 1999 criteria: Prevalence of Diabetes in India Study

This random multistage cross-sectional population survey was undertaken to determine the prevalence of type 2 diabetes mellitus (DM) in subjects aged 25 years and above in India. The study was carried out in 77 centres (42 urban and 35 rural) to reflect the size and heterogeneity of the Indian population. 18,363 (9008 male and 9355 female) subjects were studied. 10,617 (5379 males and 5238 females) were from urban areas and 7746 (3629 males and 4117 females) from rural areas. Blood samples were taken after a fast of 10-12 and 2 h after 75 g of oral glucose. Subjects were categorized as having impaired fasting glycemia (IFG) or DM using the 1997 ADA or having impaired glucose tolerance (IGT) or DM using the 1999 WHO criteria. The age- and gender-standardized prevalence rate for DM using the ADA criteria was 3.6% whilst that using the WHO criteria was 4.3% (P < 0.001). The respective standardized prevalence of DM, using the two criteria was, 4.7 and 5.6%, respectively (P < 0.001) in the urban Indian population and 2.0 and 2.7% (P < 0.02) in the rural Indian population. Using the WHO criteria, 581 subjects were newly diagnosed whilst the ADA criteria newly diagnosed 437 subjects. The respective numbers for the urban population were 425 and 323, and for the rural population were 146 and 114, respectively. The ADA criteria could diagnose 75.2, 76.0 and 73.0% of the subjects who had DM as per the WHO criteria. Of 739 Indian subjects who had IFG, 106 (14.3%) were diagnosed as having DM by the WHO criteria whilst 505 (68.3%) had values compatible with a diagnosis of IGT. Of the 536 urban subjects with IFG, 74 (13.8%) had DM and 350 (65.3%) had IGT using the WHO criteria. Of the 302 rural subjects with IFG, 32 (15.8%) had DM and 155 (76.3%) had IGT using the WHO criteria. 505 (49.9%) of 1012 Indian subjects with IGT as per the WHO criteria had IFG. 350 (47.7%) of 733 urban subjects and 155 (55.5%) of 279 rural subjects with IGT had values compatible with IFG as per the ADA criteria. Type 2 diabetes is a major health problem is India. The use of the ADA criteria would underestimate the prevalence of DM by not diagnosing subjects showing a poor response to a glucose challenge. This along with the discrepancies between subjects showing IGF or IGT could be a challenge to any prevention program.     

Usefulness of preoperative oral glucose tolerance testing for perioperative risk stratification in patients scheduled for elective vascular surgery

Patients scheduled for major vascular surgery are screened for cardiac risk factors using standardized risk indexes, including diabetes mellitus (DM). Screening in patients without a history of DM includes fasting glucose measurement. However, an oral glucose tolerance test (OGTT) could significantly improve the detection of DM and impaired glucose tolerance (IGT) and the prediction of perioperative cardiac events. In a prospective study, 404 consecutive patients without signs or histories of IGT or DM were included and subjected to OGTT. The primary study end point was the composite of perioperative myocardial ischemia, assessed by 72-hour Holter monitoring using ST-segment analysis and troponin release. The primary end point was noted in 21% of the patients. IGT was diagnosed in 104 patients (25.7%), and new-onset DM was detected in 43 patients (10.6%). The OGTT detected 75% of the patients with IGT and 72% of the patients with DM. Preoperative glucose levels significantly predicted the risk for perioperative cardiac ischemia; odds ratios for DM and IGT were, respectively, 3.2 (95% confidence interval 1.3 to 8.1) and 1.4 (95% confidence interval 0.7 to 3.0). In conclusion, the prevalence of undiagnosed IGT and DM is high in vascular patients and is associated with perioperative myocardial ischemia. Therefore, an OGTT should be considered for all patients who undergo elective vascular surgery.