Suchergebnisse

Xiaohan Tang,1–3 Xiang Yan,1–3 Houde Zhou,1,3–4 Xilin Yang,5 Xiaohong Niu,6 Jing Liu,7 Qiuhe Ji,8 Linong Ji,9 Xia Li,1–3 Zhiguang Zhou1–3 On behalf of the National Clinical Research Center for Metabolic Diseases Study Group1Department of Metabolism & Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; 2Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, Changsha, People's Republic of China; 3National Clinical Research Center for Metabolic Diseases, Changsha, People's Republic of China; 4Hunan Key Laboratory for Metabolic Bone Diseases, Changsha, People's Republic of China; 5Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, People's Republic of China; 6Department of Endocrinology, Heji Hospital Affiliated to Changzhi Medical College, Changzhi, People's Republic of China; 7Department of Endocrinology, Gansu Provincial Hospital, Lanzhou, People's Republic of China; 8Department of Endocrinology, Xijing Hospital, Fourth Military Medical University, Xi'an, People's Republic of China; 9Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, People's Republic of ChinaCorrespondence: Zhiguang ZhouDepartment of Metabolism & Endocrinology, The Second Xiangya Hospital, Central South University, No.139 Renmin Middle Road, Furong District, Changsha, Hunan 410011, People's Republic of ChinaTel +86 7 318 529 2154Email zhouzhiguang@csu.edu.cnAim: This study aimed to estimate the prevalence of latent autoimmune diabetes of adults (LADA) and classic type 1 diabetes mellitus (T1DM) in newly diagnosed adult diabetes in China.Method: This cross-sectional study involved 17,349 newly diagnosed diabetes in adults aged ≥30 years from 46 hospitals within 31 months. Demographic characteristics, clinical features, and medical history were collected by trained researchers. T1DM as a whole was comprised of classic T1DM and LADA. Classic T1DM was identified based on the clinical phenotype of insulin-dependency, and LADA was differentiated from patients with initially an undefined diabetes type with standardized glutamic acid decarboxylase autoantibody testing at the core laboratory. The age and sex distributions from a large national survey of diabetes in China conducted in 2010 were used to standardize the prevalence of classic T1DM and LADA.Results: Among 17,349 adult patients, the prevalence of T1DM was 5.49% (95% CI: 4.90–6.08%) (5.14% [95% CI: 4.36–5.92%] in males and 6.16% [95% CI: 5.30–7.02%] in females), with 65% of these having LADA. The prevalence of classic T1DM decreased with increasing age (p0.05). The prevalence of T1DM in overweight or obese patients was 3.42% (95% CI: 3.20–3.64%) and 2.42% (95% CI: 1.83–3.01%), respectively, and LADA accounted for 76.5% and 79.2% in these two groups.Conclusion: We draw the conclusion that T1DM, especially LADA, was prevalent in newly diagnosed adult-onset diabetes in China, which highlights the importance of routine islet autoantibodies testing in clinical practice.Keywords: diabetes, autoimmune, metabolism, differentiation

Juming Lu,1,* Jianping Weng,2,* Weijun Gu,1 Xiaohui Guo,3 Wenying Yang,4 Dajin Zou,5 Zhiguang Zhou,6 Dalong Zhu,7 Qiuhe Ji,8 Linong Ji,9 Xilin Yang10 1Department of Endocrinology, Chinese PLA General Hospital, Beijing, 2Department of Endocrinology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 3Department of Endocrinology, First Hospital of Peking University, Beijing, 4Department of Endocrinology, Sino-Japan Friendship Hospital, Beijing, 5Department of Endocrinology, Changhai Hospital of Shanghai, Shanghai, 6Department of Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 7Department of Endocrinology, Nanjing Drum Tower Hospital, Nanjing, Jiansu, 8Department of Endocrinology, Xijing Hospital affiliated to 4th Military Medical University, Xi'an, 9Department of Endocrinology, Peking University People's Hospital, Beijing, 10Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, People's Republic of China *These authors contributed equally to the manuscript Background: Achieving good glycemic control improves clinical outcomes among patients with type 2 diabetes (T2D). This study aimed to explore non-pharmaceutical factors for poor glycemic control in Chinese women with T2D who used antidiabetic drug(s). Methods: A cross-sectional survey was conducted in March to June 2011 in 77 top tertiary hospitals in Beijing, Shanghai, Tianjin, and Guangzhou, People's Republic of China (the coverage rates of the 3A hospitals: 74.4%, 76%, 55%, and 29.3%, respectively). Of 29,502 patients with T2D who used oral antidiabetic drugs (OADs) alone or combined with insulin, 13,970 were women and used in the analysis. Logistic regression analysis was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs) of factors for hyperglycemia defined as HbA1c (glycated hemoglobin) ≥77 mmol/mol (7.0%).Results: The mean age was 60.3 (standard deviation 11.0) years, with a median of 4 (interquartile range 2–9) years of duration of diabetes, and 65.1% had hyperglycemia. In multivariable analysis, body height of ≥164 cm (OR 1.26, 95% CI 1.15–1.37) and obesity (OR 1.16, 95% CI 1.04–1.31) was associated with increased risk of hyperglycemia, while self-monitoring blood glucose (SMBG) decreased the risk of hyperglycemia (OR 0.78, 95% CI 0.73–0.84). Duration of diabetes ≥3 years (≥3 to <6 years, OR 1.46, 95% CI 1.32–1.62; ≥6 to <10 years, OR 1.65, 95% CI 1.44–1.89), especially ≥10 years (OR 1.95, 95% CI 1.73–2.19), was associated with higher risks of hyperglycemia. Conclusion: Body height ≥164 cm, obesity, and duration of diabetes ≥3 years increased while SMBG decreased risk of hyperglycemia in Chinese women with OAD-treated T2D. Keywords: HbA1c goal, hyperglycemia, oral antidiabetic drugs