切换至 "中华医学电子期刊资源库"

中华肾病研究电子杂志 ›› 2020, Vol. 09 ›› Issue (01) : 7 -11. doi: 10.3877/cma.j.issn.2095-3216.2020.01.002

所属专题: 文献

专家论坛

2019年ADA有关糖尿病肾病诊治标准更新的解读与思考
李英1,()   
  1. 1. 050081 河北医科大学第三医院
  • 收稿日期:2019-11-18 出版日期:2020-02-28
  • 通信作者: 李英
  • 基金资助:
    国家自然科学基金资助项目(81770717)

Interpretation and reflection on the ADA′s updated standards for diagnosis and treatment of diabetic nephropathy in 2019

Ying Li1,()   

  1. 1. Department of Nephrology, Third Hospital of Hebei Medical University, Shijiazhuang 050081, Hebei Province, China
  • Received:2019-11-18 Published:2020-02-28
  • Corresponding author: Ying Li
  • About author:
    Corresponding author: Li Ying, Email:
引用本文:

李英. 2019年ADA有关糖尿病肾病诊治标准更新的解读与思考[J]. 中华肾病研究电子杂志, 2020, 09(01): 7-11.

Ying Li. Interpretation and reflection on the ADA′s updated standards for diagnosis and treatment of diabetic nephropathy in 2019[J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2020, 09(01): 7-11.

2019年美国糖尿病协会更新了《糖尿病医学诊疗标准》,并在《Diabetes Care》杂志重磅发布。新版指南在糖尿病的诊断、评估、控制以及心肾并发症的管理等方面均有所进展。尤其是糖尿病肾病的治疗药物,在心肾多方面的获益都取得了新的循证证据。本文就指南中有关糖尿病肾病患者的血糖控制、监测,病情评估,筛查以及药物治疗等方面的更新内容进行介绍。

In 2019, the American Diabetes Association (ADA) published the updated standards of medical care in diabetes in the journal of Diabetes Care. The new version of standards has made progress in the diagnosis, evaluation, and control of diabetes, as well as in the management of cardio-renal complications. In particular, the therapeutic drugs for diabetic nephropathy have gained new evidence-based results in terms of cardio-renal benefits. This article introduced the updated contents of the standards on glycemic control, monitoring, condition evaluation, screening, and drug treatment for patients with diabetic nephropathy.

[1]
Afkarian M, Zelnick LR, Hall YN, et al. Clinical manifestations of kidney disease among US adults with diabetes, 1988-2014 [J]. JAMA, 2016, 316(6): 602-610.
[2]
Wang F, Yang C, Long J, et al. Executive summary for the 2015 annual data report of the China Kidney Disease Network (CK-NET) [J]. Kidney Int, 2019, 95(3): 501-505.
[3]
Saran R, Robinson B, Abbott KC, et al. US Renal Data System 2016 annual data report: epidemiology of kidney disease in the United States [J]. Am J Kidney Dis, 2017, 69(3 Suppl 1): A7-A8.
[4]
Wen CP, Chang CH, Tsai MK, et al. Diabetes with early kidney involvement may shorten life expectancy by 16 years [J]. Kidney Int, 2017, 92(2): 388-396.
[5]
Ali MK, Bullard KM, Saaddine JB, et al. Achievement of goals in US diabetes care, 1999-2010 [J]. N Engl J Med, 2013, 368(17): 1613-1624.
[6]
American Diabetes Association. Standards of medical care in diabetes-2019 [J]. Diabetes Care, 2019, 42 (Suppl 1): S1-S193.
[7]
Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus [J]. N Engl J Med, 1993, 329(14): 977-986.
[8]
Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) Research Group. Effect of intensive diabetes therapy on the progression of diabetic retinopathy in patients with type 1 diabetes: 18 years of follow-up in the DCCT/EDIC [J]. Diabetes, 2015, 64(2): 631-642.
[9]
Ohkubo Y, Kishikawa H, Araki E, et al. Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin-dependent diabetes mellitus: a randomized prospective 6-year study [J]. Diabetes Res Clin Pract, 1995, 28(2): 103-117.
[10]
Holman RR, Paul SK, Bethel MA, et al. 10-year follow-up of intensive glucose control in type 2 diabetes [J]. N Engl J Med, 2008, 359(15): 1577-1589.
[11]
Papademetriou V, Lovato L, Doumas M, et al. Chronic kidney disease and intensive glycemic control increase cardiovascular risk in patients with type 2 diabetes [J]. Kidney Int, 2015, 87(3): 649-659.
[12]
Wong MG, Perkovic V, Chalmers J, et al. Long-term benefits of intensive glucose control for preventing end-stage kidney disease: ADVANCE-ON [J]. Diabetes Care, 2016, 39(5): 694-700.
[13]
Coresh J, Turin TC, Matsushita K, et al. Decline in estimated glomerular filtration rate and subsequent risk of end-stage renal disease and mortality [J]. JAMA, 2014, 311(24): 2518-2531.
[14]
Yun JS, Ko SH, Ko SH, et al. Presence of macroalbuminuria predicts severe hypoglycemia in patients with type 2 diabetes: a 10-year follow-up study [J]. Diabetes Care, 2013, 36(5): 1283-1289.
[15]
Aleppo G, Ruedy KJ, Riddlesworth TD, et al. REPLACE-BG: a randomized trial comparing continuous glucose monitoring with and without routine blood glucose monitoring in adults with well-controlled type 1 diabetes [J]. Diabetes Care, 2017, 40(4): 538-545.
[16]
Beck RW, Bergenstal RM, Riddlesworth TD, et al. Validation of time in range as an outcome measure for diabetes clinical trials [J]. Diabetes Care, 2019, 42(3): 400-405.
[17]
Radhakrishnan J, Cattran DC. The KDIGO practice guideline on glomerulonephritis: reading between the lines-application to the individual patient [J]. Kidney Int, 2012, 82(8): 840-856.
[18]
Fox CS, Matsushita K, Woodward M, et al. Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without diabetes: a meta-analysis [J]. Lancet, 2012, 380(9854): 1662-1673.
[19]
Lewis EJ, Hunsicker LG, Clarke WR, et al. Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes [J]. N Engl J Med, 2001, 345(12): 851-860.
[20]
Brenner BM, Cooper ME, de Zeeuw D, et al. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy [J]. N Engl J Med, 2001, 345(12): 861-869.
[21]
Garofalo C, Borrelli S, Liberti ME, et al. SGLT2 inhibitors: nephroprotective efficacy and side effects [J]. Medicina (Kaunas), 2019, 55(6): 268.
[22]
Perkovic V, Jardine MJ, Neal B, et al. Canagliflozin and renal outcomes in type 2 diabetes and nephropathy [J]. N Engl J Med, 2019, 380(24): 2295-2306.
[23]
Satman I, R Rea R, Eriksson MJ, et al. LEADER-6: baseline renal function and associated factors in a high cardiovascular risk type 2 diabetes population [J]. Diabetes Complications, 2016, 30(8): 1631-1639.
[24]
Tuttle KR, Lakshmanan MC, Rayner B, et al. Dulaglutide versus insulin glargine in patients with type 2 diabetes and moderate-to-severe chronic kidney disease (AWARD-7): a multicentre, open-label, randomised trial [J]. Lancet Diabetes Endocrinol, 2018, 6(8): 605-617.
[1] 何金梅, 尹立雪, 谭静, 张文军, 王锐, 任梅, 廖明娇. 超声心肌做功技术对2型糖尿病患者潜在左心室心肌收缩功能损伤的评价[J]. 中华医学超声杂志(电子版), 2023, 20(10): 1029-1035.
[2] 王珏, 陈赛君, 贲志飞, 詹锦勇, 徐开颖. 剪切波弹性成像联合极速脉搏波技术评估颈动脉弹性对糖尿病性视网膜病变的预测价值[J]. 中华医学超声杂志(电子版), 2023, 20(06): 636-641.
[3] 王洁, 丁泊文, 尹健. 糖尿病性乳腺病52例临床分析[J]. 中华乳腺病杂志(电子版), 2023, 17(05): 285-289.
[4] 陈絮, 詹玉茹, 王纯华. 孕妇ABO血型联合甲状腺功能检测对预测妊娠期糖尿病的临床价值[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 604-610.
[5] 张健, 刘小龙, 查天建, 姚俊杰, 王傑. 富含血小板血浆联合异种脱细胞真皮基质修复糖尿病足缺血性创面的临床效果[J]. 中华损伤与修复杂志(电子版), 2023, 18(06): 503-506.
[6] 赵雅玫, 谢斌, 陈艳, 吴健. 抗生素骨水泥联合负压封闭引流对糖尿病足溃疡临床疗效的荟萃分析[J]. 中华损伤与修复杂志(电子版), 2023, 18(05): 427-433.
[7] 贾蔓箐, 卞婧, 周业平. 对小剂量胰岛素局部注射促进脂肪干细胞移植成活及改善糖尿病创面愈合临床观察[J]. 中华损伤与修复杂志(电子版), 2023, 18(04): 312-316.
[8] 鲍亚慧, 曹志斌, 王健楠, 别瑶, 孙晓东, 惠宗光. 应用羧甲基纤维素钠银敷料联合封闭负压吸引治疗糖尿病足溃疡的疗效[J]. 中华损伤与修复杂志(电子版), 2023, 18(04): 326-330.
[9] 李琛, 张惟佳, 潘亚萍. 牙周炎与系统性疾病之间关系的应用思考:2022年EFP和WONCA欧洲分部联合研讨会共识报告的解读及启示[J]. 中华口腔医学研究杂志(电子版), 2023, 17(05): 322-327.
[10] 叶弘, 吕婧喆, 钟良军. 白藜芦醇治疗牙周炎和糖尿病的新进展[J]. 中华口腔医学研究杂志(电子版), 2023, 17(05): 376-380.
[11] 李京珂, 张妍春, 武佳懿, 任秀瑜. 深度学习在糖尿病视网膜病变筛查、评级及管理中的研究进展[J]. 中华眼科医学杂志(电子版), 2023, 13(04): 241-246.
[12] 黄岩, 刘晓巍, 杨春玲, 兰烨. 急性胰腺炎合并糖尿病患者的临床特征及血糖代谢与病情严重度的相关性[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 439-442.
[13] 张政赢, 鞠阳, 刘晓宁. 二甲双胍对2型糖尿病患者大肠腺瘤术后复发的影响[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 485-488.
[14] 薛念余, 张盛敏, 吴凌恒, 沙蕾, 童揽月, 沈崔琴, 李朝军, 杜联芳. 研究血清胆红素对2型糖尿病患者心脏结构发生改变前心肌功能的影响[J]. 中华临床医师杂志(电子版), 2023, 17(9): 1004-1009.
[15] 谢国晓, 赵凌霞, 薛雪花. 慢性病管理模式在糖尿病社区管理中的应用[J]. 中华临床医师杂志(电子版), 2023, 17(05): 587-590.
阅读次数
全文


摘要