胰岛素抵抗糖尿病与冠心病英文

17
DM
Non-DM
4 Women
% of Deaths
Mortality in People with Diabetes Causes of Death
50
40
30
20
10
0
Ischemic Other Diabetes Cancer Stroke Infection Other heart heart
Mortality per 1000 person-years*
35 29.9
30
25
20
19.2
23.0
Diabetes No Diabetes
15
11.5
10
6.3
5
11.0
7.1 3.6
0
Men
Women
Men
Women
All heart disease Ischemic heart disease
Rate per 1000 person-years
Diabetes 20
17.0
15
14.2
10
6.8 7.6
5
Nondiabetes
Men, cohort 1* Men, cohort 2** Women, cohort 1* Women, cohort 2** 7.4
4.2 2.4 1.9
0
-16.6%
Fasting Glucose
2-Hour Post Glucose Load
Diabetes Mellitus
>7.0 (>126)
>11.1 (>200)
Impaired Glucose Tolerance
>7.8 (>140) to <11.1 (<200)
Impaired Fasting Glucose
>6.1 (>110) to <7.0 (<126)
Values are mmol/L (mg/dl)
Adapted from World Health Organization. Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications. Geneva: World Health Organization:1999:52.
Hospitalization Costs for Chronic Complications of Diabetes in the US
Ophthalmic Others disease
Renal disease
Neurologic disease
Peripheral vascular disease
n=228
40
WOMEN 100
No diabetes
80
n=568
60
Diabetes
40
n=156
0 0 20 40 60 80 Months Post-MI
(P=0.46)
+10.7%
(P=0.76)
-43.8%
(P<0.001)
*Defined in 1971-1975, followed up through 1982-1984. **Defined in 1982-1984, followed up through 1992-1993. Gu K et al. JAMA 1999;281:1291-1297.
Prevalence of Diabetes in Adult Population (Aged >20 years) by Year and Region
Percent
9 8 7 6 5 4 3 2 1 0
Developed
1995
2000
2025
Developing
World
King H et al. Diabetes Care 1998;21:1414-1431.
-20.4%
(P=0.12)
Survival Post-MI in Diabetic and Nondiabetic Men and Women: Minnesota Heart Survey
Survival (%) Survival (%)
MEN 100
No diabetes
80
n=1628
60 Diabetes
Framingham Study: DM and CHD Mortality 20-Year Follow-up
Annual CHD Deaths per 1000 Persons
18
16
17
14
12
10
8
6
Байду номын сангаас
8
4
2
0
Men
Kannel WB, McGee DL. JAMA 1979;241:2035-2038.
disease disease
Geiss LS et al. In: Diabetes in America. 2nd ed. 1995; chap 11.
Mortality Due to Heart Disease in Men and Women with or without Diabetes (US)
*Age-adjusted Adapted from Gu K et al. Diabetes Care 1998;21:1138-1145.
Trends in Mortality Rates for Ischemic Heart Disease in NHANES Subjects with and without Diabetes*
Epidemiology of Insulin Resistance, Diabetes Mellitus, and Coronary Heart Disease
Steven Haffner, MD
Criteria for the Diagnosis of Diabetes Mellitus and Hyperglycemia Plasma Glucose Concentration
Total costs 12 billion US $
CVD accounts for 64% of total costs
Cardiovascular disease
American Diabetes Association. Economic Consequences of Diabetes Mellitus in the US in 1997. Alexandria, VA: American Diabetes Association, 1998:1-14.