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인슐린 비의존형 당뇨병 환자에서의 당뇨병 유병기간에 의한 미세혈관 합병증 발생 시기의 추정
원영준(Young Jun Won),신영구(Young Goo Shin),심광용(Kwang Yong Shim),홍애라(Ae La Hong),송창호(Chang Ho Song),정춘희(Choon Hee Chung),서병기(Byeong Ki Seo) 대한내과학회 1996 대한내과학회지 Vol.51 No.4
N/A Objectives: Microvascular complications in NID-DM patients have a positive correlation with the duration of diabetes. However, it is difficult to know about the duration of diabetic period before clinical diagnosis that the microvascular complications have been progressed, Harris et al previously presented in Diabetes Care that the patients with NIDDM had the prediagnostic period of 4-7 years before clinical diagnosis. We can find frequently the microvascular complications at the time of clinical diagnosis of diabetes, and thus assume that the microvascular complications have developed before the clinical diagnosis of diabetes. We estimate the periods, between the onset of diabetes and its clinical diagnosis in Korean diabetic patients. Methods - We studied 281 NIDDM patients who were admitted at Wonju Christian Hospital from January 1993 to July 1994. Weighted linear regression was performed to examine the relationship between the duration of diabetes and the prevalence of microvascular complications of diabetes. We can find the linear relationship between the two parameters (prevalence and duration of diabetes). By extraplotting at this linear relationship to the time when the prevalence of microvaseular complication was estimated to be zero, the time of onset of detectable complication was calculated. Results: 1) Prevalence of neuropathy at clinical diagnosis of diabetes was estimated to be 35.9%, and neuropathy has occurred 10.6 years before the clinical diagnosis of NIDDM. 2) Prevalencd of retinopathy at clinical diagnosis of diabetes was estimated to be 21.6%, and retinopathy has occurred 6.4 years before the clinical diagnosis of NIDDM. 3) In the cases of nephropathy, the correlation between the duration of diabetes and the prevalence was not statistically significant. Conclusion: In our study, the microvascular complications may develop several years before the clinical diagnosis of diabetes, and therefore, checkup for the microvascular complications is essential at the diagnosis of diabetes.