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Objective To strengthen hypoglycemic treatment of elderly type 2 diabetic complications and quality of life, and to explore the relationship between CRP and vascular complications and vascular disease risk factors, provide a theoretical basis for the development of the complications of diabetes prevention and treatment strategies, which ultimately improve the quality of life of patients. July 2002 to 12 enrolled in this clinical drug research center of 97 elderly patients with type 2 diabetes by the International Center of ADVANCE were randomly divided into the intensive treatment group (48 cases), and the standard treatment group (49 cases). The intensive group Gliclazide sustained release-based treatment programs, HbA1c target value of 6.5%, standard set of local guidelines based on an average follow-up of 5 years. Regular follow-up and detected two groups of FBG, HbA1c, and biochemical indicators, fill in the the MMSE and quality of life questionnaire (EQ-5D) and collect pertinent findings; fifth year follow-up of the biochemical markers simultaneous determination of high-sensitivity CRP. Results ① last follow-up, strengthening the group average HbA1c level (6.3%) less than the standard group (7.0%), the difference was significant (P lt; 0.05). The composite endpoint of incidence of vascular events in the intensive group and the standard group were 14.6% and 34.7%, new-onset microalbuminuria was 14.6% and 32.7%, respectively, and the difference was significant (P lt; 0.05). Five years in strengthening the group number of episodes of mild hypoglycemia was significantly higher than the standard group (P lt; 0.05). The difference remained significant (P lt; 0.05) (2) in the two dimensions of quality of life in the actions and activities of daily living, abnormal number of macrovascular complications group than macrovascular complications group increased significantly, regression analysis. The microvascular complications VAS scores significantly lower than those without microvascular complications, and in three dimensions in the day-to-day activities, pain, anxiety, abnormal number of people than the latter significantly increased regression analysis, microvascular complications VAS score daily activities and pain still significant effect (P lt; 0.05). In the year before the last follow-up, low blood sugar attack group compared to patients with no hypoglycemia episodes obvious anxiety difference significant sex (P lt; 0.05). Intensive group compared with the standard set of five dimensions of quality of life and VAS was no significant difference. Apply multiple regression equation to analyze the impact of quality of life factors, found that female patients with pain and anxiety is more pronounced than that of men (P lt; 0.05); larger the the age greater the chance of pain (P lt; 0.05); longer duration partners more pain and anxiety (P lt; 0.05), the worse the quality of life VAS score (P lt; 0.05); higher the educational level the higher the VAS score (P lt; 0.05); BMI is higher in operations and daily activities more (P lt; 0.05). Found no impact on quality of life SBP and HbA1c. ③ macrovascular complications group than elevated CRP levels without complications, were 5.72 (2.85, 8.39) 3.76 (1.74, 4.57) mg / L, the difference was statistically significant (P lt; 0.05). CRP and gender, microvascular complications and cardiovascular risk factors such as age, duration of diabetes, blood pressure, BMI, HbA1c, serum TG, TC, HDL-C, LDL, urine A / C and were not found there is a correlation. Conclusion ① strengthen hypoglycemic therapy can significantly reduce the composite endpoint of vascular events and the occurrence of microalbuminuria increased significantly, but the onset of hypoglycemia. The ② diabetes prevalence of anxiety and pain. The vascular complications significantly affect the patient's quality of life. Hypoglycaemic episodes in patients with widespread anxiety. Intensive glucose lowering treatment on quality of life there was no significant impact. To ③ women, senior citizens, long duration, low level of education and the quality of life of patients with high body mass index is even worse. ④ serum CRP levels and macrovascular complications significantly related, no correlation with gender, age, blood pressure, duration of diabetes, BMI, HbA1c, TG, TC, HDL-C, LDL, urine A / C and microvascular complications.
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