Gaps and barriers in the control of blood glucose in people with type 2 diabetes.
Gaps and barriers in the control of blood glucose in people with type 2 diabetes.
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DOI：
10.1177/1479164116679775
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发表时间：
2017-05
影响因子：
2.4
通讯作者：
Global Partnership for Effective Diabetes Management
中科院分区：
文献类型：
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作者：
Blonde L;Aschner P;Bailey C;Ji L;Leiter LA;Matthaei S;Global Partnership for Effective Diabetes Management
在很大一部分2型糖尿病患者中，血糖控制是次优的，因此他们潜在严重并发症的风险增加，而且是可以避免的。我们试图通过回顾最近科学文献中的相关出版物来探索医疗保健专业人员的态度和做法，这些态度和做法可能有助于次优血糖控制。从2011年1月至2015年7月，对PubMed数据库进行了电子搜索，以确定相关出版物。对电子搜索的补充是对2014/2015年主要糖尿病会议摘要的手动搜索，可在网上获得。最近公布的数据表明，在相当一部分(通常为40%-60%)的糖尿病患者中，血糖控制是次优的。这种情况在各地理区域以及低收入和高收入国家都是如此。治疗惰性似乎是导致多达一半的2型糖尿病患者血糖控制不佳的重要因素。特别是，开处方的人往往愿意忍受长期的“轻度”高血糖，同时对患者的期望值也很低。在需要时，启动或加强降糖治疗通常会延迟3 年或更长时间。许多2型糖尿病患者在目前的治疗中失败了，大约一半的患者没有达到或维持适当的目标血糖水平，这使得这些患者面临着增加的和可以避免的严重并发症的风险。这篇评论文章的方法在“方法”一节中有详细介绍。
Glycaemic control is suboptimal in a large proportion of people with type 2 diabetes who are consequently at an increased and avoidable risk of potentially severe complications. We sought to explore attitudes and practices among healthcare professionals that may contribute to suboptimal glycaemic control through a review of recent relevant publications in the scientific literature. An electronic search of the PubMed database was performed to identify relevant publications from January 2011 to July 2015. The electronic search was complemented by a manual search of abstracts from key diabetes conferences in 2014/2015 available online. Recently published data indicate that glycaemic control is suboptimal in a substantial proportion (typically 40%–60%) of people with diabetes. This is the case across geographic regions and in both low- and higher-income countries. Therapeutic inertia appears to be an important contributor to poor glycaemic control in up to half of people with type 2 diabetes. In particular, prescribers are often willing to tolerate extended periods of ‘mild’ hyperglycaemia as well as having low expectations for their patients. There are often delays of 3 years or longer in initiating or intensifying glucose-lowering therapy when needed. Many people with type 2 diabetes are failed by current management, with approximately half not achieving or maintaining appropriate target blood glucose levels, leaving these patients at increased and avoidable risk of serious complications. The methodology of this review article is detailed in the ‘Methods’ section.