Management of type 2 diabetes with multiple oral hypoglycaemic agents or insulin in primary care: retrospective cohort study.
Management of type 2 diabetes with multiple oral hypoglycaemic agents or insulin in primary care: retrospective cohort study.
复制标题
初级保健中使用多种口服降糖药或胰岛素治疗 2 型糖尿病：回顾性队列研究。
DOI：
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复制
发表时间：
2007
期刊：
影响因子：
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通讯作者：
N. Freemantle
中科院分区：
文献类型：
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作者：
M. Calvert;R. McManus;N. Freemantle
背景
强化血糖控制可以降低 2 型糖尿病患者发生微血管并发症的风险。
目的
检查服用口服药物和/或胰岛素的 2 型糖尿病患者的监测和血糖控制程度，并调查向胰岛素的过渡。
研究设计
回顾性队列研究。
设置
1995 年至 2005 年间，英国共有 154 个常规实践为 DIN-LINK 数据库做出了贡献。
方法
使用读取代码和处方数据来识别 2 型糖尿病患者。结果测量为：多种口服药物和/或胰岛素的血糖监测和控制，以及向胰岛素的过渡。
结果
共有 14 824 名 2 型糖尿病患者同时服用多种口服药物，其中 5064 名患者 (34.16%) 在最后一次口服治疗开始前和开始后 6 个月进行了血红蛋白 A(1c) (HbA(1c)) 评估。治疗前平均 HbA(1c) 为 9.07%，治疗后降至 8.16%（平均差 0.91%，95% 置信区间 [CI] = 0.86 至 0.95，P <0.0001）。在进行 HbA(1c) 评估的患者中，有 3153 名 (62.26%) 患者治疗后血糖控制不佳。服用多种口服药物的患者使用胰岛素的中位时间为 7.7 年（95% CI = 7.4 至 8.5 年）； 1513 名受试者在研究期间开始使用胰岛素，并在使用胰岛素之前和之后 6 个月进行了 HbA(1c) 评估。胰岛素治疗前平均 HbA(1c) 为 9.85%（标准差 [SD] 1.96%），治疗后下降了 1.34%（95% CI = 1.24% 至 1.44%），但 1110 人 (73.36%) 的 HbA(1c) 仍≥7.5%。
结论
许多 2 型糖尿病患者监测不足，血糖控制不佳。需要强化管理以降低微血管并发症的风险。
BACKGROUND
Intensive glycaemic control can reduce the risk of microvascular complications in people with type 2 diabetes.
AIM
To examine the extent of monitoring and glycaemic control of patients with type 2 diabetes prescribed oral agents and/or insulin, and to investigate transition to insulin.
DESIGN OF STUDY
Retrospective cohort study.
SETTING
A total of 154 general practices in the UK contributing to the DIN-LINK database between 1995 and 2005.
METHOD
People with type 2 diabetes were identified using Read codes and prescribing data. Outcome measures were: glycaemic monitoring and control on multiple oral agents and/or insulin, and transition to insulin.
RESULTS
A total of 14 824 people with type 2 diabetes were prescribed multiple oral agents concurrently, of whom 5064 (34.16%) had haemoglobin A(1c) (HbA(1c)) assessments 6 months before and following initiation of their last oral therapy. Mean HbA(1c) before therapy was 9.07%, which dropped to 8.16% following therapy (mean difference 0.91%, 95% confidence interval [CI] = 0.86 to 0.95, P <0.0001). Of the patients with HbA(1c) assessments, 3153 (62.26%) had evidence of poor glycaemic control following therapy. Median time to insulin for patients prescribed multiple oral agents was 7.7 years (95% CI = 7.4 to 8.5 years); 1513 people began insulin during the study and had HbA(1c) assessments 6 months before and following insulin. Mean HbA(1c) before insulin was 9.85% (standard deviation [SD] 1.96%) which decreased by 1.34%, (95% CI = 1.24% to 1.44%) following therapy, but 1110 people (73.36%) still had HbA(1c) > or =7.5%.
CONCLUSION
Many people with type 2 diabetes received inadequate monitoring and had poor glycaemic control. Intensive management is required to reduce the risk of microvascular complications.
胰岛素和糖尿病。
DOI：
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发表时间：
1986
期刊：
Transactions of the Association of American Physicians
影响因子：
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作者：
Mako,ME;Rubenstein,AH
通讯作者：
Rubenstein,AH