糖尿病による障害を避けるための推奨血糖値(Recommended blood sugar levels to avoid diabetes-related damage)

1型糖尿病の人が目や腎臓の合併症を発症するリスクを正確に判断するには、長期間の血糖値のレベルを利用することができる。1型糖尿病発症後、30年以上にわたって個人を追跡調査した研究によると、この値は53mmol/mol(7%)より低くなければなりません。 The levels of long-term blood sugar can be used to accurately determine the risk of a person with type 1 diabetes developing eye- and kidney complications. This level should be lower than 53 mmol/mol (7%), according to a study that has followed individuals for more than 30 years after the onset of type 1 diabetes

.2022-09-12 スウェーデン・リンショーピング大学

Continuous monitoring of glucose is used by people with diabetes. Habrovich

<関連情報>

• https://liu.se/en/news-item/sa-lagt-bor-blodsockret-vara-for-att-inte-ge-skador-vid-diabetes
• https://diabetesjournals.org/care/article-abstract/doi/10.2337/dc22-0239/147518/Impact-of-HbA1c-Followed-32-Years-From-Diagnosis

1型糖尿病診断から32年間追跡したHbA1cが重症網膜症および腎症の発症に与える影響:VISS試験 Impact of HbA1c Followed 32 Years From Diagnosis of Type 1 Diabetes on Development of Severe Retinopathy and Nephropathy: The VISS Study

Hans J. Arnqvist;Malin C. Westerlund;Mats Fredrikson;Johnny Ludvigsson;Maria Nordwall
Diabetes Care  Accepted:July 30 2022
DOI:https://doi.org/10.2337/dc22-0239

OBJECTIVE
To evaluate HbA_1c followed from diagnosis, as a predictor of severe microvascular complications (i.e., proliferative diabetic retinopathy [PDR] and nephropathy [macroalbuminuria]).

RESEARCH DESIGN AND METHODS
In a population-based observational study, 447 patients diagnosed with type 1 diabetes before 35 years of age from 1983 to 1987 in southeast Sweden were followed from diagnosis until 2019. Long-term weighted mean HbA_1c (wHbA_1c) was calculated by integrating the area under all HbA_1c values. Complications were analyzed in relation to wHbA_1c categorized into five levels.

RESULTS
After 32 years, 9% had no retinopathy, 64% non-PDR, and 27% PDR, and 83% had no microalbuminuria, 9% microalbuminuria, and 8% macroalbuminuria. Patients with near-normal wHbA_1c did not develop PDR or macroalbuminuria. The lowest wHbA_1c values associated with development of PDR and nephropathy (macroalbuminuria) were 7.3% (56 mmol/mol) and 8.1% (65 mmol/mol), respectively. The prevalence of PDR and macroalbuminuria increased with increasing wHbA_1c, being 74% and 44% in the highest category, wHbA_1c >9.5% (>80 mmol/mol). In comparison with the follow-up done after 20–24 years’ duration, the prevalence of PDR had increased from 14 to 27% and macroalbuminuria from 4 to 8%, and both appeared at lower wHbA_1c values.

CONCLUSIONS
wHbA_1c followed from diagnosis is a very strong biomarker for PDR and nephropathy, the prevalence of both still increasing 32 years after diagnosis. To avoid PDR and macroalbuminuria in patients with type 1 diabetes, an HbA_1c <7.0% (53 mmol/mol) and as normal as possible should be recommended when achievable without severe hypoglycemia and with good quality of life.