1、從高血糖與糖尿病周圍神經(jīng)病變的關(guān)系反思研究和控制策略,北京大學(xué)人民醫(yī)院 紀(jì)立農(nóng),China Cardiometabolic Registries,2,Nation-wide, prospective, registry series designed to better understand clinical outcomes of current treatment of cardiovascular and metabolic diseases in real world settings,Organized by Chinese Medical Doctor Associations S

2、upervised by CCMR International Advisory Board Managed by VitalStrategic Research Institute,China Cardiometabolic Registries,研究者會(huì)議2011 年 5 月 14-15 日,中國2型糖尿病患者心血管疾病危險(xiǎn)因素的縱向隊(duì)列研究,中國老年學(xué)學(xué)會(huì)（GSC）主辦 中國醫(yī)師協(xié)會(huì)心血管內(nèi)科醫(yī)師分會(huì)(CCCP) 協(xié)辦 中國醫(yī)師協(xié)會(huì)內(nèi)分泌及代謝科醫(yī)師分會(huì)(CEA) 協(xié)辦 中國心血管代謝病系列研究(CCMR) 組織及專家委員會(huì) 指導(dǎo) 華斯泰生命策略研究所/上海華斯泰醫(yī)學(xué)咨詢有限公司 (VS

3、RI) 執(zhí)行 默沙東(中國)有限公司贊助,Nationwide Assessment of Cardiovascular Risk Factors-Blood Pressure, Blood Lipid, and Blood Glucose in Chinese Patients with Type 2 Diabetes,Linong Ji Peking University Peoples HospitalOn behalf of CCMR Advisory Board,Ji et al. AJM，2013，in press,Study Objectives Primary,Primary

4、Objective To assess the level of control of CVD risk factors, including blood pressure, blood lipid, and blood glucose, in outpatients with type 2 DM in 6 representative regions in China and in three tiers of hospitals To identify the gap between real world diabetes management situation and standard

5、 of care,4,Ji et al. AJM，2013，in press,Study Objectives - Secondary,Secondary Objectives To assess the proportion of microvascular and macrovasclar diabetic complications in outpatients with type 2 DM To assess real-life treatment patterns in outpatients with type 2 DM To assess the proportion of hy

6、poglyecemia under the current treatment To assess the influencing factors (hospital classification, regional distribution, medical history, educational level and others) on DM treatment outcomes,5,Ji et al. AJM，2013，in press,Non-interventional, observational, cross-sectional design Type 2 diabetes d

7、iagnosed for 6 months or longer Ambulatory patients from endocrinology, cardiology, nephrology clinics in all 3 tiers of hospitals (Tier 1, 2, and 3) located in all 6 main regions in China Estimated sample size was 25,000 patients in order to have sufficient power to detect the difference of the pri

8、mary assessment in each region,6,6,6,Study Design,Targeted to enroll 25,000 patients,Ji et al. AJM，2013，in press,Distribution of Participating Hospitals,7,Number of sites in each region was proportional to the population in the region,Ji et al. AJM，2013，in press,Characteristics of study subjects,8,M

9、ean age = 62.6 +/-11.9 years,Ji et al. AJM，2013，in press,Distribution of CVD Risk Factors,28% of the patients had T2D only 60% of the patients also had HTN (T2D+HTN) About 42% of the patients also had DYLP (T2D+DYLP) About 30% of the patients had “3B”: high blood glucose, blood lipid, and blood pres

10、sure (T2D+HTN+DYLP),9,T2D = type 2 diabetes, HTN = hypertension, DYLP = dyslipidemia,Ji et al. AJM，2013，in press,Diabetes Duration and Complications,10,Prevalence of diabetic complications is proportional to duration of diabetes,(%),Duration of Diabetes,Ji et al. AJM，2013，in press,Diabetic Complicat

11、ions and CVD Risk Factors,11,(%),Ji et al. AJM，2013，in press,Callaghan BC ，et al. Cochrane Database Syst Rev. 2012,Callaghan BC ，et al. Cochrane Database Syst Rev. 2012,Callaghan BC ，et al. Cochrane Database Syst Rev. 2012,Callaghan BC ，et al. Cochrane Database Syst Rev. 2012,Callaghan BC ，et al. Co

12、chrane Database Syst Rev. 2012,Callaghan BC ，et al. Cochrane Database Syst Rev. 2012,Callaghan BC ，et al. Cochrane Database Syst Rev. 2012,Callaghan BC ，et al. Cochrane Database Syst Rev. 2012,Callaghan BC ，et al. Cochrane Database Syst Rev. 2012,Callaghan BC ，et al. Cochrane Database Syst Rev. 2012

13、,Callaghan BC ，et al. Cochrane Database Syst Rev. 2012,Callaghan BC ，et al. Cochrane Database Syst Rev. 2012,Gde, P. et. al. N Engl J Med 2003;348:383-393,Results from Patients withType 2 Diabetes - STENO 2,Diabetic Neuropathy in Type 2 Patients,Patients can be classified into 2 groups based on myelinated fiber density loss over 52 weeks,MFD,Sural nerve biopsies of 427 patients,TRIGLYCERIDES,Wiggin et al, Diabetes, 2009,Gde, P. et. al. N Engl J Med 2003;348:383-393,Diabetic Neuropa