糖尿病前期和2型糖尿病的查:美国预防服务工作组的最新证据报告和系统审查
Daniel E Jonas1,2, Karen Crotty1,3, Jonathan D Y Yun4
1RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center, Chapel Hill.
2型糖尿病查没有显示死亡率的好处,但对糖尿病前期和最近诊断的糖尿病的干预改善了健康结果. 生活方式的改变和甲素显著降低了糖尿病发病率,改善了中间标志物.
科学领域:
- 内分泌学和代谢疾病
- 预防医学
- 公共卫生
背景情况:
- 二型糖尿病是一种普遍的疾病,对患病率和残疾有很大影响.
- 有效的查策略和干预措施对于管理糖尿病前期和糖尿病至关重要.
研究的目的:
- 综合关于糖尿病前期和糖尿病查的证据.
- 为美国预防服务工作组 (USPSTF) 的建议提供信息.
主要方法:
- 对糖尿病前期/糖尿病查和干预措施的受控研究进行系统审查.
- 通过2019年9月进行文献搜索,并通过2021年5月进行监视.
- 双重审查,定性综合和89个出版物的元分析 (68,882名参与者).
主要成果:
- 糖尿病查试验没有显著的死亡益处或明显的危害证据.
- 对于最近被诊断为糖尿病患者,密集的血糖控制 (硫尿素,胰岛素,甲胺) 改善了健康结果.
- 对糖尿病前期的生活方式干预降低了糖尿病发病率 (综合RR,0. 78) 和改善了中间结果 (体重,BMI,血压).
- 甲素还显著降低了糖尿病发病率 (合并RR,0. 73) 并有助于体重控制.
结论:
- 糖尿病查缺乏证明的死亡益处,对其他结果和危害的数据有限.
- 对已诊断的糖尿病和糖尿病前期的干预措施有效改善健康结果并减少疾病发病率.
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