主题：【原创】说说糖尿病, 地震和血糖 (上）(增补一个试验） -- wan1234

To examine the short- and long-term influences of the Marmara earthquake, which occurred on August 17, 1999 in Turkey, on glycemic control and quality of life (QOL), HbA1c, insulin requirement and QOL of 88 people with type 1 diabetes living in the quake zone were evaluated one year before (PreE), 3 months after (PostE) and one year after (FE) the earthquake. HbA1c levels and daily insulin requirements increased significantly at PostE (HbA1c from 7.4 .+-. 1.3% to 8.5 .+-. 1.8%, p<0.05; insulin from 0.58 .+-. 0.2 IU/kg/day to 0.77 .+-. 0.2 IU/kg/day, p<0.05). Mean total QOL scores at PostE were significantly lower than the scores obtained at PreE (62.7 .+-. 17.3 vs 74.2 .+-. 13.4, p<0.001). There were no significant differences between HbA1c levels and total QOL scores at PreE and FE. People with type 1 diabetes living in the same house after the earthquake and not having enough food supply were reported to have lower QOL than people moving to another house and having enough food supply after the earthquake (p = 0.014, p<0.0001, respectively). The Marmara Earthquake had a negative impact on the glycemic control and QOL of the subjects with type 1 diabetes for the short term but prequake scores might be achieved after a long period. (author abst.)

Abstract

At 5:56 p.m. on October 23, 2004, a major earthquake of magnitude 6.8 on the Richter scale struck the Chuetsu district of Niigata Prefecture, Japan, a rural area with mountain villages. Strong aftershocks of grade 5–6 on the Japanese Intensity Scale continued for 2 months. We investigated changes in the HbA1c levels of 65 type 1 diabetic patients with insulin therapy before and throughout the 12 months of aftershocks that followed the earthquake. All patients received insulin therapy via pens with replaceable cartridges or continuous subcutaneous insulin infusion (CSII). Most patients needed four daily insulin injections with rapid- and long-acting insulins. Nineteen percent of patients had the CSII therapy using rapid-acting insulin. The mean HbA1c level in all patients increased significantly (P < 0.01) from 6.7 ± 0.9% to 7.0 ± 1.0% in the third month, peaked at the fifth month, and decreased at 12 months. Sixty percent of the patients stayed in their own houses after the initial shock, while 40% of patients moved into other houses. Seventeen percent of the patients had severely destroyed houses. The median PTSD score was low in all patients. Within 1 month after the earthquake, the pens with replaceable cartridges were discontinued and disposable pens with prefilled insulin cartridges were used. The incidence of nephropathy increased by 7% by the third month and returned to the pre-earthquake level by the sixth month. Over the 12-month observation period, no other micro- or macro-vascular diseases were newly diagnosed. One patient had transient severe acute hyperglycemia and one needed hemodialysis. However, none of the patients had ketoacidosis, and no other clinical manifestations of disease were noted.

In conclusion, it is essential that neighboring organizations respond quickly with sufficient medical support for diabetic patients with insulin therapy following an earthquake. In particular, treatment with rapid- and long-acting insulin injections via disposable pens with prefilled insulin cartridges or CSII therapy is useful during a disaster. To take the medical support, patients should always have a note or copy of their medical records, including medical history and medications used.