Do age and comorbidity affect intensity of pharmacological therapy for poorly controlled diabetes mellitus?
Do age and comorbidity affect intensity of pharmacological therapy for poorly controlled diabetes mellitus?
复制标题
年龄和合并症是否会影响控制不佳的糖尿病的药物治疗强度？
DOI：
10.1111/j.1532-5415.2005.53370.x
复制
发表时间：
2005
影响因子：
6.3
通讯作者：
Concato,John
中科院分区：
文献类型：
--
作者：
Chaudhry,SarwatI;Berlowitz,DanR;Concato,John
目的：研究年龄和合并症对糖尿病（DM）控制不佳患者强化药物治疗的影响。设计：观察性队列研究，使用退伍军人事务部（VA）国家数据库的数据。设置：新英格兰、佛罗里达和波多黎各的13个VA医疗中心。参与者：接受常规医疗护理的DM控制不佳的退伍军人（N= 5，317）。测量：如果开始使用新的降糖药物或增加现有药物的剂量，则认为在访视时存在降糖药物或强化治疗。结果：强化治疗的总体发生率为20.8%（1，106/5，317）。无合并症的最年轻患者的强化率最高（24.5%），合并症的最年长患者的强化率最低（15.7%）（P<0.001）。结论：在所有组中，单次门诊访视时的强化率都很低，合并症的老年患者的强化率最低。
Objectives:To examine the influence of age and comorbidity on intensification of medical therapy for patients with poorly controlled diabetes mellitus (DM).Design:Observational cohort study using data from Department of Veterans Affairs (VA) national databases.Setting:Thirteen VA medical centers in New England, Florida, and Puerto Rico.Participants:Veterans (N=5,317) with poorly controlled DM receiving regular medical careMeasurements:An increase in hypoglycemic medications, or intensification of therapy, was considered present at the visit if a new hypoglycemic medication was started or the dosage of an existing medication was increased.Results:The overall rate of intensification of therapy was 20.8% (1,106/5,317). The rate of intensification was highest in the youngest patients without comorbidity (24.5%) and lowest in the oldest patients with comorbidity (15.7%) (P<.001).Conclusion:Rates of intensification at a single clinic visit were quite low in all groups and were lowest in older patients with comorbidity.