分布在不同治疗单元的住院老年2型糖尿病人的降糖方案分析
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摘要
目的分析分布在不同治疗单元的老年2型糖尿病人的降糖治疗方案。方法收集368位住院的老年2型糖尿病人资料,分为心血管疾病组、脑血管疾病组、老年病组、内分泌组,评价降糖方案的合理性。结果二甲双胍、阿卡波糖的使用均存在禁忌证(P>0.05),非内分泌专业组使用二甲双胍的不合理现象较多。共有59.2%的病人使用2种以上的降糖药物,出现了降糖药物相互间的作用以及降糖药物与烟酒、降糖药物与其他口服药物的相互作用。结论老年2型糖尿病人的降糖治疗方案需要综合考虑年龄、肝肾功能、胰岛功能、合并疾病、药物相互作用等因素。建议制订住院糖尿病人的管理计划,指定专人负责管理和协调有关住院糖尿病人管理的治疗系统。
OBJECTIVE To analysis of hypoglycemic treatment in elderly type 2 diabetic patients with different treatment units.METHODS Collect 368 data of hospitalized elderly type 2 diabetes patients, Divided into cardiovascular disease group,cerebrovascular disease group,senile disease group,endocrine group. We evaluation of rationality of Sugar reduction Program.RESULTS The use of metformin and acarbose had contraindications( P > 0. 05). There were more unreasonable use of metformin in non-endocrine specialty grup. More than half of the patients use more than 2 hypoglycemic drugs. There were interactions between hypoglycemic drugs,hypoglycemic drugs and tobacco and alcohol,hypoglycemic drugs and other oral drugs. CONCLUSION Age,liver and kidney function,islet function,complicated disease and drug interaction should be taken into account in the treatment of type2 diabetes mellitus. It is recommended that a management plan for hospitalized diabetic patients be drawn up. A designated person is responsible for the management and coordination of the treatment system for hospitalized diabetics.
OBJECTIVE To analysis of hypoglycemic treatment in elderly type 2 diabetic patients with different treatment units.METHODS Collect 368 data of hospitalized elderly type 2 diabetes patients, Divided into cardiovascular disease group,cerebrovascular disease group,senile disease group,endocrine group. We evaluation of rationality of Sugar reduction Program.RESULTS The use of metformin and acarbose had contraindications( P > 0. 05). There were more unreasonable use of metformin in non-endocrine specialty grup. More than half of the patients use more than 2 hypoglycemic drugs. There were interactions between hypoglycemic drugs,hypoglycemic drugs and tobacco and alcohol,hypoglycemic drugs and other oral drugs. CONCLUSION Age,liver and kidney function,islet function,complicated disease and drug interaction should be taken into account in the treatment of type2 diabetes mellitus. It is recommended that a management plan for hospitalized diabetic patients be drawn up. A designated person is responsible for the management and coordination of the treatment system for hospitalized diabetics.
引文
[1]中国老年学会老年医学会老年内分泌代谢专员委员会.老年糖尿病诊疗措施专家共识(2013年版)[J].中华内科杂志,2014,53(3):243-251.
[2]田慧,李春霖,杨光,等.二甲双胍在老年2型糖尿病患者应用的安全性评估[J].中华内科杂志,2008,47(11):914-918.
[3]杨光,李春霖,田慧,等.老年2型糖尿病患者使用二甲双胍后血乳酸水平的变化[J].中国药物应用与监测,2008,5(2):12-15.
[4]中华医学会内分泌学分会.中国成人2型糖尿病胰岛素促泌剂应用的专家共识[J].中华内分泌代谢杂志,2012,28(4):261-265.
[5]梁志远,廖建军,林县杰.老年糖尿病患者治疗过程中发生严重低血糖的危险因素分析[J].牡丹江医学院学报,2016,37(4):32-34.
[6]孙般若,李春霖.老年糖尿病患者降糖治疗的分层管理和治疗策略[J].中国医学前沿杂志(电子版),2012,4(3):27-30.
[7]国际糖尿病联盟.老年2型糖尿病管理全球指南[S].2014.
[8]Josep Franch-Nadal,Fermín García-Gollarte,Alfonso Pérez del Moli-no,et al. Physicians'and Pharmacists'Clinical Considerations forElderly Patients with Type 2 Diabetes Mellitus:The IMPLICA2Study[J]. Clinical Drug Investigation,2018,10(12):1-12
[2]田慧,李春霖,杨光,等.二甲双胍在老年2型糖尿病患者应用的安全性评估[J].中华内科杂志,2008,47(11):914-918.
[3]杨光,李春霖,田慧,等.老年2型糖尿病患者使用二甲双胍后血乳酸水平的变化[J].中国药物应用与监测,2008,5(2):12-15.
[4]中华医学会内分泌学分会.中国成人2型糖尿病胰岛素促泌剂应用的专家共识[J].中华内分泌代谢杂志,2012,28(4):261-265.
[5]梁志远,廖建军,林县杰.老年糖尿病患者治疗过程中发生严重低血糖的危险因素分析[J].牡丹江医学院学报,2016,37(4):32-34.
[6]孙般若,李春霖.老年糖尿病患者降糖治疗的分层管理和治疗策略[J].中国医学前沿杂志(电子版),2012,4(3):27-30.
[7]国际糖尿病联盟.老年2型糖尿病管理全球指南[S].2014.
[8]Josep Franch-Nadal,Fermín García-Gollarte,Alfonso Pérez del Moli-no,et al. Physicians'and Pharmacists'Clinical Considerations forElderly Patients with Type 2 Diabetes Mellitus:The IMPLICA2Study[J]. Clinical Drug Investigation,2018,10(12):1-12