在难以控制的2型糖尿病中,高皮质醇症的患病率
John B Buse1, Steven E Kahn2, Vanita R Aroda3
1University of North Carolina School of Medicine, Chapel Hill, NC.
Diabetes care
|April 18, 2025
概括
过高皮质醇症是一种皮质醇过多的情况,影响了近四分之一的2型糖尿病患者,尽管服用药物,血糖仍无法控制. 这突出了改善糖尿病管理中的血糖控制的潜在目标.
科学领域:
- 内分泌学 在内分泌学.
- 代谢障碍 代谢障碍 代谢障碍
- 糖尿病研究 糖尿病研究
背景情况:
- 2型糖尿病的管理往往无法在大量患者群体中实现血糖指标.
- 过高皮质醇是潜在的,但未被认可的,导致2型糖尿病高血糖的原因.
研究的目的:
- 为了确定患有2型糖尿病和不充分控制的血糖的人群中高皮质醇症的患病率.
- 在这个人群中识别与高皮质醇症相关的因素.
主要方法:
- 一项前性观察性研究,涉及1,057名2型糖尿病患者,接受多种降血糖药物治疗.
- 使用1毫克德甲抑制试验 (DST) 进行查,DST后皮质醇>1.8μg/dL定义高皮质醇.
- 后勤回归分析以确定相关特征.
主要成果:
- 过高皮质醇症的患病率为23.8% (252/1,057).
- 患有心脏疾病 (33.3%) 和多种抗高血压药物 (36.6%) 患者的患病率更高.
- 相关因素包括特定的糖尿病和血压药物,年龄较大,BMI较低,非拉丁裔/西班牙裔种族以及纤维酸或止痛药的使用.
结论:
- 高皮质醇症在2型糖尿病患者中大约有四分之一患有低于最佳的血糖控制.
- 识别和解决高皮质醇症可能为改善这种具有挑战性的患者群体的葡萄糖管理提供了一个新的策略.
相关概念视频
Diabetes Mellitus: Type 2 and Gestational
2.1K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
2.1K
Carbohydrate Metabolism
10.5K
Carbohydrates are polymers composed of molecules containing atoms of carbon, hydrogen and oxygen. One gram of carbohydrate can provide four kilo-calories of energy, which makes it the most efficient instant energy source.
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
10.5K
Pathophysiology of Diabetes
807
Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
807
Diabetes Mellitus: Overview and Type I Subtype
2.3K
Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
2.3K
Diabetes: Symptoms, Diagnosis, and Complications
475
For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
475
Psychoneuroimmunology: Diabetes and Cancer
19
Chronic stress has been linked to both the onset and progression of serious health conditions, including Type 2 diabetes and cancer. Type 2 diabetes, a widespread chronic illness, is closely associated with obesity and insulin resistance, both of which often worsen under stress. Studies indicate that men experiencing high levels of chronic stress face a 45% higher risk of developing diabetes compared to those with minimal stress. Stress triggers physiological responses that elevate blood...
19


