住院2型糖尿病患者降糖药物使用情况分析
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摘要
目的探讨住院2型糖尿病(T2DM)患者的用药情况。方法选取苏州市中医医院内分泌科2018年1—12月收治的240例T2DM患者,根据降糖方案分为口服降糖药组、口服降糖药+胰岛素组、胰岛素组,根据药物联用情况分为单药治疗组、两联治疗组、三联以上治疗组,比较不同降糖药物联用方案的控制血糖效果。结果降糖药物使用频次由高到低依次为α-糖苷酶抑制剂、胰岛素、双胍类、格列奈类、磺脲类、噻唑烷二酮类、DPP-4抑制剂、SGLT2抑制剂、GLP-1受体激动剂;口服降糖药组的病程、糖化血红蛋白(Hb A1c)水平均明显低于口服降糖药+胰岛素组和胰岛素组(均P<0.05),口服降糖药组空腹血糖(FPG)及餐后2h血糖(2h PBG)下降幅度均明显低于其他两组(P<0.05);三联以上治疗组的体重指数(BMI)、Hb A1c水平明显高于单药治疗组和两联治疗组(P<0.05)。结论 T2DM的降糖方案以口服降糖药+胰岛素为主,常用降糖药物为二甲双胍、阿卡波糖、胰岛素等,但胰岛素使用时机存在偏差,需进一步加强患者对胰岛素的认识。
Objective To explore the medication status of hospitalized patients with type 2 diabetes mellitus(T2DM). Methods A total of 240 patients with T2DM admitted to the department of endocrinology of Suzhou Hospital of Traditional Chinese Medicine from January to December 2018 were selected. According to the hypoglycemic scheme, they were divided into oral hypoglycemic drug group, oral hypoglycemic drug + insulin group and insulin group. According to the combined use of drugs, they were divided into single-drug group, 2-drug-combined group and multi-drug-combined group. The effects of different hypoglycemic schemes on blood sugar control were compared. Results According to the frequency of usage from high to low, hypoglycemic drugs were α-glucosidase inhibitors, insulin, biguanides, glinides, sulfonylureas, thiazolidinediones, DPP-4 inhibitors, SGLT2 inhibitors and GLP-1 receptor agonists. The course and glycated hemoglobin(HbA1 c) level of oral hypoglycemic drug group were significantly lower than those of oral hypoglycemic drug + insulin group and insulin group(P<0.05). The fasting blood glucose(FPG) and 2 hours postprandial blood glucose(2hPBG) in the oral hypoglycemic drug group were decreased more significantly than those in the other 2 groups(P<0.05). The body mass index(BMI) and HbA1 c level in the multi-drug-combined group were significantly higher than those in the single-drug group and the 2-drug-combined group(P<0.05). Conclusion The main hypoglycemic scheme of T2DM in this hospital is oral hypoglycemic drug + insulin. The commonly used hypoglycemic drugs are metformin, acarbose, insulin, etc. However, there are some deviations in the timing of insulin use. It is necessary to further strengthen patients' understanding of insulin.
Objective To explore the medication status of hospitalized patients with type 2 diabetes mellitus(T2DM). Methods A total of 240 patients with T2DM admitted to the department of endocrinology of Suzhou Hospital of Traditional Chinese Medicine from January to December 2018 were selected. According to the hypoglycemic scheme, they were divided into oral hypoglycemic drug group, oral hypoglycemic drug + insulin group and insulin group. According to the combined use of drugs, they were divided into single-drug group, 2-drug-combined group and multi-drug-combined group. The effects of different hypoglycemic schemes on blood sugar control were compared. Results According to the frequency of usage from high to low, hypoglycemic drugs were α-glucosidase inhibitors, insulin, biguanides, glinides, sulfonylureas, thiazolidinediones, DPP-4 inhibitors, SGLT2 inhibitors and GLP-1 receptor agonists. The course and glycated hemoglobin(HbA1 c) level of oral hypoglycemic drug group were significantly lower than those of oral hypoglycemic drug + insulin group and insulin group(P<0.05). The fasting blood glucose(FPG) and 2 hours postprandial blood glucose(2hPBG) in the oral hypoglycemic drug group were decreased more significantly than those in the other 2 groups(P<0.05). The body mass index(BMI) and HbA1 c level in the multi-drug-combined group were significantly higher than those in the single-drug group and the 2-drug-combined group(P<0.05). Conclusion The main hypoglycemic scheme of T2DM in this hospital is oral hypoglycemic drug + insulin. The commonly used hypoglycemic drugs are metformin, acarbose, insulin, etc. However, there are some deviations in the timing of insulin use. It is necessary to further strengthen patients' understanding of insulin.
引文
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[3]纪立农,吴晶,陈颖丽,等.中国大中城市2型糖尿病降糖药物治疗患者药物使用调查分析[J].中国药学杂志,2012,47(9):736-738.
[4]母义明,纪立农,宁光,等.二甲双胍临床应用专家共识(2016年版)[J].中国糖尿病杂志,2016,24(10):871-884.
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