Hyperglycemia is the essential reason for diabetic complications ●DCCT Diabetes Control and Complications Trial ● UKPDS United Kingdom Prospective Diabetes Study
Hyperglycemia is the essential reason for diabetic complications ⚫ DCCT Diabetes Control and Complications Trial ⚫ UKPDS United Kingdom Prospective Diabetes Study
UKPTS: results o HbAlclo.9%, (intensive therapy vs routine therapy Intensive therapy group: diabetis associated complications 12%,and the fatalness of microvascular complications 25% o It cannot evidently reduce the incidence of great vessel disease such as miocardial infarction and strock o Most stimulating findings: Biguanides can prevent or slow the onset and/or progression of diabetic complications in overweight patients o Tight control of hypertension can prevent or slow the onset and/or progression of diabetic complications by 24% (144/82mmHg vs 154/87mmHg), stroke by 44% microvascular complications by 37%0
UKPTS：results ⚫ HbA1c 0 .9%，（intensive therapy vs routine therapy） ⚫ Intensive therapy group: diabetis associated complications 12%，and the fatalness of microvascular complications 25%。 ⚫ It cannot evidently reduce the incidence of great vessel disease ,such as miocardial infarction and strock . ⚫ Most stimulating findings：Biguanides can prevent or slow the onset and/or progression of diabetic complications in overweight patients ⚫ Tight control of hypertension can prevent or slow the onset and/or progression of diabetic complications by 24% （144/82mmHg vs 154/87mmHg） ，stroke by 44%， microvascular complications by 37%
Epidemiology of diabetes Macrovascular disease o diabetics are easy to get atherosclerosis Monckeberg's sclerosis 41.5% Intimal arteriosteogenesis 29.3% e Coronary heart disease, cerebrovascular disease: 24 times Risk of miocardial infarction: 10 times Risk of stroke: 3.8 times, especially in women o Risk of lower limb amputation 15times, fatalness
Epidemiology of diabetes Macrovascular disease ⚫ Diabetics are easy to get atherosclerosis – Monckeberg’s sclerosis 41.5％ – Intimal arteriosteogenesis 29.3％ ⚫ Coronary heart disease、cerebrovascular disease：24 times – Risk of miocardial infarction： 10 times – Risk of stroke : 3.8 times，especially in women ⚫ Risk of lower limb amputation：15times ，fatalness
Hypertension in DM Morbidity rate ◆ diabetes:20%~40% Diabetes in EU(35-54years) 30%0-50% +Diabetes in China: 29. 2% ● pathogenesis +aortosclerosis Arteriola resistance +Hypertension associated with Dn t Renal hypertension caused by stenosis of renal arter
Hypertension in DM Morbidity rate diabetes: 20%40% Diabetes in EU(35-54years): 30%50% Diabetes in China: 29.2% pathogenesis aortosclerosis Arteriola resistance Hypertension associated with DN Renal hypertension caused by stenosis of renal artery
Diabetic Retinopathy o Diabetic retinopathy-leading course of new cases of blindness o Pathogeny: state of illness course of disease, age of onset o <5 years eyeground disease is not common o <10 years 50% eyeground disease <20 years: 80-90 %eyeground disease
⚫ Diabetic retinopathy－leading course of new cases of blindness ⚫ Pathogeny：state of illness 、course of disease、age of onset ⚫ <5 years ：eyeground disease is not common ⚫ <10 years ：50％eyeground disease ⚫ <20 years ：8090％eyeground disease Diabetic Retinopathy