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The Australian Diabetes, Obesity, and Lifestyle Study
Elizabeth L.M. Barr åt al. Risk of Cardiovascular and All-Cause Mortality in Individuals With Diabetes Mellitus, Impaired Fasting Glucose, and Impaired Glucose Tolerance. The Australian Diabetes, Obesity, and Lifestyle Study (AusDiab) Circulation 2007, 18 June
Background--Diabetes mellitus increases the risk of cardiovascular disease (CVD) and all-cause mortality. The relationship between milder elevations of blood glucose and mortality is less clear. This study investigated whether impaired fasting glucose and impaired glucose tolerance, as well as diabetes mellitus, increase the risk of all-cause and CVD mortality. Methods and Results--In 1999 to 2000, glucose tolerance status was determined in 10 428 participants of the Australian Diabetes, Obesity, and Lifestyle Study (AusDiab). After a median follow-up of 5.2 years, 298 deaths occurred (88 CVD deaths). Compared with those with normal glucose tolerance, the adjusted all-cause mortality hazard ratios (HRs) and 95% confidence intervals (CIs) for known diabetes mellitus and newly diagnosed diabetes mellitus were 2.3 (1.6 to 3.2) and 1.3 (0.9 to 2.0), respectively. The risk of death was also increased in those with impaired fasting glucose (HR 1.6, 95% CI 1.0 to 2.4) and impaired glucose tolerance (HR 1.5, 95% CI 1.1 to 2.0). Sixty-five percent of all those who died of CVD had known diabetes mellitus, newly diagnosed diabetes mellitus, impaired fasting glucose, or impaired glucose tolerance at baseline. Known diabetes mellitus (HR 2.6, 95% CI 1.4 to 4.7) and impaired fasting glucose (HR 2.5, 95% CI 1.2 to 5.1) were independent predictors for CVD mortality after adjustment for age, sex, and other traditional CVD risk factors, but impaired glucose tolerance was not (HR 1.2, 95% CI 0.7 to 2.2). Conclusions--This study emphasizes the strong association between abnormal glucose metabolism and mortality, and it suggests that this condition contributes to a large number of CVD deaths in the general population. CVD prevention may be warranted in people with all categories of abnormal glucose metabolism. [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] |
#2
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Ðåçóëüòàòû, êîíå÷íî. îæèäàåìûå, íî óäðó÷àþùèå.. Êîëè÷åñòâî ýòèõ ñìåðòåé áóäåò ðàñòè, àäåêâàòíîå âåäåíèå ýòèõ ïàöèåíòîâ òðåáóåò áîëüøèõ âëîæåíèé (ðàçíûõ ðåñóðñîâ), ÷èñëî èõ ðàñòåò. à ïðîôèëàêòèêà ñëîæíà..
Âñå íà áîðüáó ñ ãèïîäèíàìèåé è èçáûòî÷íûì âåñîì!
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Àííà, âðà÷-ýíäîêðèíîëîã Âîðîíåæ, êëèíèêà Íåïëàöåáî |
#3
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Íàäî ïåðåâåñòè äëÿ "Îæèðåíèå è ïåðååäàíèå"
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#4
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 âûõîäíûå ìîãó ïåðåâåñòè - òîëüêî íàäî òîãäà åùå ÷òî-òî íàéòè äëÿ íîâîñòåé îæèðåíèÿ. ïîèñêàòü?
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Àííà, âðà÷-ýíäîêðèíîëîã Âîðîíåæ, êëèíèêà Íåïëàöåáî |
#5
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Íàâåðíîå, äîëæíû ñî âðåìåíåì ðàçâèàòüñÿ êàðäèî-ýíäîêðèíîëîãè÷åñêèå îòäåëåíèÿ, â êîòîðûõ âðà÷è èìåþò ñïåöèàëèçàöèþ ýíäîêðèíîëîãà+êàðäèîëîãà.
Áåç ãðàìîòíîãî ëå÷åíèÿ íàðóøåíèé óãëåâîäíîãî îáìåíà, îæèðåíèÿ, çàáîëåâàíèé ùèòîâèäíîé æåëåçû è äðóãèõ ýíäîêðèííûõ áîëåçíåé, ïðîòåêàþùèõ ñ ïîðàæåíèåì ñåðäå÷íî-ñîñóäèñòîé ñèñòåìû, êàðäèîëîãàì ñëîæíî ñïðàâëÿòüñÿ ñî ñâîèìè çàäà÷àìè. |
#6
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À åùå ëó÷øå - ýòî ïðîñòî îòäåëåíèÿ, ãäå ðàáîòàþò òîëüêî ñåñòðè÷êè, à âðà÷è - ÷òî êàðäèîëîã, ÷òî ýíäîêðèíîëîã, ïðèõîäÿò òîëüêî êîíñóëüòèðîâàòü è íàáëþäàòü. Çà÷åì ïëîäèòü òàêèå óçêèå ñïåöèàëüíîñòè?
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#7
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Öèòàòà:
Ýòî øèðå, ÷åì ïðîñòî êàðäèîëîã èëè ýíäîêðèíîëîã. È íóæíû òàêèå âðà÷è ñåé÷àñ íó î÷åíü ñèëüíî! |
#8
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À çà÷åì èõ ãîñïèòàëèçèðîâàòü â ñïåö îòäåëåíèÿ è âîîáùå ãîñïèòàëèçèðîâàòü? Òåðàïåâò íå ñïðàâèòñÿ? Äæåíåðàë ïðàêòèñèîíå, òàê ñêàçàòü..
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#9
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Èíòåðåñíî, ïîäîáíîå èññëåäîâàíèå ìîæíî îðãàíèçîâàòü è ïðîâåñòè ó íàñ?
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#10
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Ãîñïèòàëèçèðîâàòü - ïî ïîêàçàíèÿì, êîíå÷íî.
Êðîìå øóòîê, ñåðäå÷íî-ñîñóäèñòàÿ ñìåðòíîñòü áûëà áû íèæå, åñëè áû â îòäåëåíèÿõ êàðäèîðåàíèìàöèè âðà÷è ãðàìîòíî âåëè áû ñîïóòñòâóþùèé äèàáåò, åñëè áû âñåãäà àäåêâàòíî ëå÷èëè ïàöèåíòîâ ñ íàðóøåíèÿìè ô-öèè ùèòîâèäíîé æåëåçû, åñëè áû íå ïðîïóñêàëè ñïëîøü è ðÿäîì àðòåðèàëüíûå ãèïåðòîíèè ýíäîêðèííîãî ãåíåçà (õîòÿ áû âñïîìèíàëè, ÷òî òàêèå åñòü!).  ìåä èíñòèòóòàõ öèêëû ýíäîêðèíîëîãèè ìàëåíüêèå, êóöûå. Çíàíèÿ â ýòîé îáëàñòè ó òåðàïåâòîâ, êàðäèîëîãâ, ðåàíèìàòîëîãîâ, êàê ïðàâèëî, îñòàâëÿþò æåëàòü ëó÷øåãî... Âîò è âîçíèêëà ìå÷òà-èäåÿ î êàðäèî-ýíäîêðèíîëîãå! |
#11
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Ïî ìîåìó, âñå çàèíòåðåñîâàííûå â ñâîåé ðàáîòå ýíäîêðèíîëîãè è òàê ìîãóò íàçûâàòüñÿ êàðäèî-ýíäîêðèíîëîãàìè
À åùå ñåðäå÷íî-ñîñóäèñòàÿ ñìåðòíîñòü áûëà áû íèæå, åñëè áû êàðäèîëîãè è òåðàïåâòû ñòàòèíû è áåòà-áëîêåðû íàçíà÷àëè òåì. êîìó îíè íóæíû. Â÷åðà ïðèíèìàëà ìóæ÷èíó ñ ÑÄ. â àíàìíåçå 2 èíôàðêòà, â íàçíà÷åíèÿõ ñòàòèíîâ íåò (âèäåëà âûïèñêè), íà ñëîâàõ êàðäèîëîãîì ðåêîìåíäîâàíî êàæäûé äåíü ñúåäàòü ïî êóñî÷êó ñàëà "äëÿ ñíèæåíèÿ õîëåñòåðèíà".  îáùåì, âîïðîñ îá îáùåì óðîâíå êâàëèôèêàöèè, ÈÌÕÎ.
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Àííà, âðà÷-ýíäîêðèíîëîã Âîðîíåæ, êëèíèêà Íåïëàöåáî |
#12
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Öèòàòà:
Âîò òîëüêî äèàáåòèêè ñ èíôàðêòàìè ïîïàäàþò, óâû, íå ê ýíäîêðèíîëîãàì... |
#13
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Ïðîñïåêòèâíîå èññëåäîâàíèå ( ñïîíñîð - NIH) - "Look - Ahead " ðåêðóòèðîâàíî 5000 áîëüíûõ ñ äèàáåòîì 2 òèïà, ïóáëèêàöèÿ ðåçóëüòàòîâ çàïëàíèðîâàíà 2012 ãîäó -11 ëåòíåå èññëåäâîàíèå ñ öåëüþ ñíèæåíèÿ ìàññû òåëà íà 10% ( ðóêîâîäèòåëü - D Ryan)
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Ã.À. Ìåëüíè÷åíêî |
#14
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 Ðîññèè ìîæíî ïðîâåñòè ïîäîáíûå èññëåäîâàíèÿ?
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