小時糖耐量試驗的臨床意義【特薦-文庫吧資料
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【正文】 R after adj. for updated GHb until end of DCCT (or CV event during DCCT): 16% (64 – 57) P= Intensive Insulin Rx amp。 17 yrs altogether GHb Results: DCCT End EDIC End Intensive () () Conventional () () Intensive Insulin Rx amp。 OR documented angina。 OR CV death。 CVD: T1 DM DCCT/EDIC NEJM 2022。 23: 290:48694 The main changes from baseline to 3 years: Acarbose Placebo STOPNIDDM Trial (3) Body Weight (kg) BMI (kg/m2) Waist (cm) SysBP (mmHg) DiasBP (mmHg) 2hPG (mmol/L) Triglycerides (mmol/L) All p for the difference between the two groups Summary ? Diabetes diagnosed by either FPG or 2h criteria are risk factor for CVD disease, but 2h criteria identify those who are not diabetic by FPG alone ? IGT is over IFG with regard to the prediction of the CVD ? More trials are required to show that intensive treatment of postprandial hyperglycemia can reduce the CVD RCT Metaanalysis: G Lowering Type 1 Diabetes Trials Am Heart J 2022。 26:29102914 Effect of intensive glycemic control on the risk for any type of macrovascular events C Stettler, Am Heart J 2022。 47: 385394 Nondiabetic Diabetic Followup Baseline 2hPG NGT IGT Nondiabetic CHD incidence CVD mortality Allcause mortality Incidence density (no./per 1000 personyears) Qiao et al. Diabetes Care 2022。 26: 688696 010002022300040001 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 1701234513 .02 h o u r pla s ma g luc o s e ( mm o l/ l)CVD mortality by 2hour plasma glucose Frequency Hazard ratio DECODE, Diabetes Care 26: 688696 CVD mortality by fasting plasma glucose 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 170123450202240006000800010000 8 . 5 4 . 0F a s t ing pla s ma glu c o s e ( mm o l/ l)Frequency Hazard ratio DECODE, Diabetes Care 26: 688696 Hazard ratio for mortality by FPG categories, the DECODA Study FPG (mmol/l) (n=5547) (n=462) ? (n=297) P for trend CVD Model 1 Model 2 1 1 () () () () Allcause Model 1 Model 2 1 1 () () () () Model 1: Adjusted for age, sex, cohort, BMI, sysBP, Chol and smoking Model 2: Additional adjustment for 2hPG DECODA Study Group, Diabetologia 2022。 26: 6169. Hazards ratio for allcause mortality in subjects without prior history of diabetes Adj. for age, cohorts, sex, chol, BMI, SBP, smoking 2,011,491,77 ? – ? – Fasting plasma glucose (mmol/l) Hazard ratio Adapted from DECODE Study Group, Lancet 1999。 26: 6169. 051015202530354045I F G amp。317:371–375 Classification of individuals the DECODE Study 2 ho ur plas ma glucose (mmol/l) FPG (mmol/l) – 11 .0 ? 11 .1 To ta l – 12443 621 1984 476 291 255 14718 1352 ? 101 119 449 669 T
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