探寻东西方2型糖尿病的差异——从现象到本质的思考

Differences between East and West type 2 diabetes——From phenomenon to essence

根据IDF最新糖尿病地图数据显示,全球成年糖尿病患者已达4.15亿,数年来呈总体增长趋势。本文对国内外循证证据进行归纳整理,发现东西方T2DM患者在流行病学、诊疗现状和临床特点等方面存在一定差异:东方患者的发病率和餐后血糖较高,诊疗率、BMI和发病年龄较低。遗传因素、发病机制及治疗反应的不同是造成差异的内在原因。本文针对东西方T2DM从现象到本质的差异进行思考和总结,旨在探讨适合中国患者的管理策略,包括提高诊断率和治疗率、重视餐后血糖的检测和控制及胰岛β细胞功能的评估,适时起始适合中国患者的胰岛素治疗方案。

According to the latest IDF Diabetes Atlas,the number of adult with type 2diabetes in the world has reached a total of 415 million,and in a growth trend these years.Here,we summarized the current differences between eastern and western type 2diabetes by reviewing the domestic and international studies of evidence-based medicine.We found that there were differences in epidemiology,diagnosis,treatment status and clinical characteristics between eastern and western type 2diabetes mellitus.For example,the incidence rate of diabetes and the postprandial blood glucose are higher while the body mass index（BMI）,the age of onset and the rate of diagnosis and treatment are lower in the East.Genetic factors,pathogenesis,and treatment response are the internal causes of the differences.This paper makes reflection and summary according to the illustrated differences between East and West type 2diabetes from phenomenon to essence,to explore the management strategies of type 2diabetes mellitus in China,improve diagnostic rate and treatment rate,pay attention to postprandial blood glucose detection and control,attach importance to the evaluation of patients beta cell function and timely initiation of suitable insulin therapy for patients with diabetes in China.