常州市30～59岁农村人群空腹血糖受损流行病学调查

目的分析常州市30~59岁农村居民空腹血糖受损及糖尿病的流行特征。方法采用随机整群的抽样方法,对常州市农村地区6 913名常住居民进行问卷调查并测量身高、体重、腰围、血压和空腹血糖等指标,根据2000年第5次全国人口普查资料对现患率进行年龄标化。结果空腹血糖受损患病率为5.28%,标化率为4.74%,男和女标化患病率分别为5.21%和4.43%。随着年龄和BMI的增加,IFG患病率呈显著升高趋势（Ptend均〈0.0001）。结论常州农村地区人群IFG患病率较高,应重视和加强宣传和早期预防控制工作。     

葡萄糖耐量试验对早期糖尿病筛查及转归的预测研究

目的:研究糖尿病早期筛查的意义,评估其胰岛素敏感性及分泌功能,同时预测其发生糖尿病及其相关并发症的转归情况,为临床早期干预提供指导?方法:通过对患者进行口服葡萄糖耐量试验(OGTT),计算其体质指数,同时行血脂检测,早期筛查糖尿病并评估其胰岛素敏感性?结果:糖耐量减低(IGT)组患者平均年龄低于糖尿病(DM)组(52.0±10.9 vs 65.1±14.3,P < 0.05);与正常葡萄糖耐量(NGT)组患者相比,空腹血糖调节受损(IFG)组?IGT组患者及DM组患者胰岛素敏感性(ISI0,120)明显下降,胰岛素抵抗明显(NGT vs IFG:92.0±22.3 vs 69.1±22.0;NGT vs IGT:92.0±22.3 vs 64.7±13.1;NGT vs DM 92.0±22.3 vs 28.5±8.2,P < 0.05);IGT组患者较IFG组患者胰岛素敏感性下降更明显(IFG vs IGT 69.1±22.0 vs 64.7±13.1,P < 0.05);胰岛素生成指数(IGI)IGT组明显高于IFG组(IFG vs IGT:1.69±0.80 vs 1.90±1.20,P < 0.05);与NGT组相比,IFG组及DM组胰岛素早期相分泌(EPIR)明显降低(NGT vs IFG 1stPH:243.9±173.5 vs 124.2±110.2,2ndPH:99.2±33.5 vs 62.6±37.4;NGT vs DM 1stPH:243.9±173.5 vs 136.7±123.2,2ndPH:99.2±33.5 vs 38.8±33.3,P < 0.05);且IGT组高于IFG组(IFG vs IGT 1stPH:124.2±110.2 vs 200.4±186.3,P < 0.05)?结论:IFG患者与IGT患者可能存在不同的发病机制,部分患者在正常葡萄糖耐量(NGT)时已经存在β细胞功能受损,OGTT检查对于揭示胰岛分泌功能及胰岛素抵抗,早期筛查糖尿病具有重要的意义,从而对糖尿病早期诊断早期干预提供临床指导意义?     

采用新的空腹血糖标准对社区高血压患者调查结果分析

目的:探讨社区高血压病人,采用空腹血糖新的下切点标准,血糖异常检出的结果和意义.方法:2003年12月～2005年4月期间,我院社区门诊高血压病人100例,进行空腹血糖检测,并进行75g葡萄糖耐量实验(OGTT),按新糖尿病(DM)诊断标准,将病人分为2组,对其结果进行分析.结果:非DM组20人空腹血糖(87.7±6.0)mg/dL,糖耐量异常80人.其中新诊断DM46人,其空腹血糖(149.0±41.9)mg/dL,P＜0.01;新诊断IGT的34人,其空腹血糖(113.9±12.7)mg/dL,P＜0.01[其中空腹血糖受损(IFG)/糖耐量受损(IGT)15人,单纯IFG 12人,单纯IGT 7人].结论:高血压合并DM比例很高.按新IFG标准可以增加DM的检出率.     

北京市海淀区糖尿病流行病学调查

[目的]探讨海淀区糖尿病流行现况。[方法]采用等比例多阶段整群随机抽样的方法,抽取海淀区18岁以上常住居民2773人进行问卷调查、体格检查及血液生化指标的测定。[结果]海淀区糖尿病患病率为11.0%,空腹血糖受损率为5.70%,男性患病率高于女性,二者差异有统计学意义(P﹤0.05)。糖尿病患病率随年龄的增长有明显上升的趋势(趋势χ2=259.12,P﹤0.01),70岁以上组达23.60%,且与职业、文化程度、体重指数有关。文化程度越低、体重指数越高,糖尿病患病率越高,小学及以下文化程度为18.56%,肥胖组达19.62%。糖尿病的知晓率、药物治疗率、控制率分别为62.95%、55.08%、23.61%。[结论]海淀区居民的糖尿病患病率较3年前有所升高,糖尿病的知晓率、药物治疗率、控制率无明显提高,针对危险因素进行干预、降低糖尿病的患病率是当前亟待解决的问题。     

Effects of lifestyle changes on adults with prediabetes: A systematic review and meta-analysis

Aims

To assess the efficacy, safety, and cost-effectiveness of lifestyle intervention, compared with treatment as usual in people with prediabetes as defined by the American Diabetes Association. For older studies, we used the 1985 World Health Organization definition.

厦门市开元社区老年居民糖尿病和空腹血糖受损患病率调查分析

目的：探讨厦门市开元社区老年居民糖尿病（DM）、空腹血糖受损（IFG）患病率及危险因素分析。方法：以厦门市开元社区65岁以上老年人908例为调查对象,进行问卷调查,测量血压、体重、身高、腰围,检测空腹血糖、OGTT2h血糖、血脂等指标,并进行统计学分析。结果：被调查的908例老年居民中共查出糖尿病患者249例,患病率为27.4%,其中既往诊断糖尿病者142例,新诊断糖尿病107例,新诊断糖尿病检出率为11.78%;IFG患者223例,患病率为24.6%;有高血压病史、血脂异常、肥胖人群糖尿病的患病率升高。多元逐步回归分析提示,甘油三酯、腰围是65岁以上老年人新发糖尿病及IFG的危险因素。结论：积极开展社区DM及IFG的筛查,建立以社区为基础的综合干预管理对促进糖尿病防治整体水平的提高有重要的意义。     

Effects of prediabetes and diabetes on left ventricular and coronary microvascular functions

Background

Coronary flow reserve (CFR) provides independent prognostic information in diabetic patients with known or suspected coronary artery disease. However, there have been no substantial data to evaluate CFR in prediabetics. Accordingly, we aimed to evaluate CFR in subjects with prediabetes using second harmonic transthoracic Doppler echocardiography.

Methods and Results

We measured CFR of 65 subjects with prediabetes, 45 patients with overt type 2 diabetes, and 43 sex and age matched normoglycemic healthy subjects with normal glucose tolerance. Ages, gender, existence of hypertension or hypercholesterolemia, smoking status were similar among the groups. CFR was significantly lower in diabetics (2.15 ± 0.39) than in prediabetics (2.39 ± 0.45) and controls (2.75 ± 0.35); in addition, it was significantly lower in prediabetics than controls. Only 2 (5%) of control subjects had abnormal CFR (< 2) but 11 (17%) prediabetic subjects and 19 (42%) diabetic patients had abnormal CFR. We found that only age (β = − 0.31, P < 0.01) and presence of the diabetes (β = − 0.57, P < 0.01) were significant predictors of lower CFR in a multivariable model that adjusted for other variables. CFR was significantly and inversely correlated with age (r = − 0.15, P = 0.04), fasting glucose level (r = − 0.27, P = 0.001), postprandial glucose level (r = 0.43, P < 0.001), hemoglobin A1C level (r = − 0.34, P < 0.001), LDL cholesterol level (r = 0.22, P = 0.009), mitral A velocity (r = − 0.27, P = 0.001) and Tei index (r = − 0.19, P = 0.02), whereas mitral E/A ratio, mitral Em (r = 0.18, P = 0.02), mitral Em/Am ratio (r = 0.23, P = 0.004) were significantly and positively correlated with CFR.

Conclusion

CFR is impaired in subjects with prediabetics, but this impairment is not as severe as that in diabetics.     

The prevalence of impaired fasting glucose and type 2 diabetes in a population‐based sample of overweight/obese children in the Middle East

Moadab MH, Kelishadi R, Hashemipour M, Amini M, Poursafa P. The prevalence of impaired fasting glucose and type 2 diabetes in a population‐based sample of overweight/obese children in the Middle East. Background: Type 2 diabetes mellitus (T2DM) and impaired fasting glucose (IFG) are increasing in young population who are facing an escalating trend of overweight. The aim of this study was to determine the prevalence of IFG and T2DM for the first time in a population‐based sample of Iranian obese children. Methods: This cross‐sectional, population‐based study was conducted in Isfahan, the second large city of Iran. Overall, 672 overweight and obese school students, selected from 7554 students, aged 6–19 yr, were screened for IFG and T2DM. Fasting plasma glucose (FPG) and lipid profile were measured in all participants. Oral glucose tolerance test and insulin level were measured in those children with IFG. Insulin resistance was defined as homeostasis model assessment for insulin resistance (HOMA‐IR) > 3.10. Results: Among the7554 students (48.7% boys and 51.3% girls) studied, 9.34% (n = 706) were overweight and 5.3% (n = 403) were obese. A number of 672 overweight and obese students including 302 (44.9%) boys and 370 (55.1%) girls, with a mean age of 12.8 ± 3.10 yr underwent biochemical work up. Overall, the prevalence of IFG was 4.61% (n = 31), the corresponding figure was 2% (n = 4) in the 6–10 yr age group, and 5% (n = 27) in those aged 10.1–19 yr. The prevalence of T2DM was 0.1% (n = 1; age, 18.00 yr). Impaired glucose tolerance and insulin resistance were detected in three and six participants with IFG, who consisted 0.4 and 0.8% of total obese and overweight students, respectively. Conclusions: Although the prevalence of T2DM is low in Iranian obese children, IFG is not uncommon. Preventive measures and screening of FPG should be considered for these children.