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[ADA2009]John D. Brunzell教授访谈:综合干预危险因素,全面降低心血管风险
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作者:国际糖尿病网 2009/6/13 15:27:00    加入收藏
内容概要:心血管病变是糖尿病主要的并发症之一。尽早评价和控制心血管危险对于降低患者死亡率、提高生活质量十分重要。患有不同类型糖尿病的患者,其发生心血管病变的危险性是一样的吗?


采访实录:

International Diabetes: Cardiovascular disease is one of the major complications in diabetes mellitus, it is important to assess and manage cardiovascular risk as soon as possible to reduce the mortality of these patients and improve their quality of life. As to patients with different types of diabetes, do you think they have the same risk of developing cardiovascular disease?
国际糖尿病:心血管疾病是糖尿病主要并发症之一,及早评价并处理心血管危险因素对降低这些患者病死率和改善生活质量很重要。您认为不同类型糖尿病患者发生心血管疾病的风险相同吗?

Prof. Brunzell: I think to answer your question, one of the major causes, if not the major cause of death in type-II diabetes is cardiovascular disease and that is related to obesity, insulin resistance and the dyslipidemia and hypertension that go along with it. Type-I diabetes I think is a different story. In the past, about a third of type-I diabetics deaths were due to myocardial infarction by the age of 55. However with an onset in the change of diabetic diet, treatment of hypertension and using drugs to prevent kidney disease and coronary disease, but most importantly intensive diabetes treatments with insulin pump for multiple injections, has decreased the kidney disease in type-I diabetes and coronary disease has almost gone away in type-I diabetes, with the exception of those who, paradoxically, gained a lot of weight with insulin therapy and developed central obesity insulin resistance, and began to look like type-II diabetics, and I think in fact their risk in modern times might be similar to that we see in type-II diabetics.
Brunzell教授: 我想这样可以回答你的问题,主要原因之一,如果不是2型糖尿病死亡的主要原因,是心血管疾病,并且它和与之相伴随的肥胖、胰岛素抵抗、血脂异常和高血压相关。我想1型糖尿病就不同了。在过去,大约三分之一1型糖尿病患者在55岁时死于心肌梗死。不过,随着糖尿病饮食的改善、高血压的治疗和药物预防肾病及冠心病,最重要的是应用胰岛素泵多次注射来强化糖尿病治疗,使得1型糖尿病肾病减少,冠心病也几乎从1型糖尿病中消失。除非有些人看似矛盾地在应用胰岛素治疗时增加了许多体重并发展成中心性肥胖和胰岛素抵抗,类似2型糖尿病。我认为在现代他们的风险类似于2型糖尿病。




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