摘要
目的 了解上海社区糖尿病患者的降糖药物使用情况及其效果,为该地区糖尿病患者用药提供依据.方法 数据来源于2018年上海社区糖尿病流病学调查研究数据库,年龄≥18岁目前居住于此区域或居住时间≥6个月的成年人4612名纳入此项研究.根据药物使用情况将人群分为未用药组、单药组、双药联合组及多药联合组,比较不同用药分组患者的空腹血糖、糖化血红蛋白、BMI及糖尿病并发症的患病率.结果 4612名患者中有70.9%使用降糖药物,其中34.8%的人使用二甲双胍,35.1%使用磺酰脲类,22.9%使用α糖苷酶抑制剂,13.8%使用胰岛素.在糖尿病并发症的患病率中,联合用药者的糖尿病性肾病、视网膜病变、神经病变、脑卒中、糖尿病足的患病率较未用药者及单药使用者高(P<0.01).总人群中HbA1C<7%者仅有41.3%,其中未用药组的患者空腹血糖和HbA1C值比所有用药组的都低,HbA1C达标率较其他组高(P<0.01).随着用药数量的增加,HbA1C越不容易达标(P<0.01),总人群中BMI<24 kg/m2的患者占42.2%,而4组之间的BMI达标率差异无统计学意义(P>0.05).结论 不论是单药降糖还是多药联合降糖,上海社区糖尿病患者降糖使用频数较高的药物是二甲双胍、磺酰脲类、α糖苷酶抑制剂、胰岛素.上海社区糖尿病患者血糖控制效果欠佳.其中,多药联合降糖者,糖尿病病程较长,HbA1C达标率较低,而糖尿病并发症患病率也越高.
Objective To investigate the use of diabetes medications and their effects on the community diabetic patients in Shanghai,China,and provide the evidence for the use of antidiabetic drugs in diabetic patients in the region.Methods The data were from a database of a 2018 Survey on Community Diabetes Mellitus in Shanghai,China.There were 4612 subjects included in this cross-sectional study in 2018.According to the use of antidiabetic drugs,the population was divided into untreated group,single drug group,double drugs combination group and multi-drugs combination group,to compare the fasting blood glucose,glycosylated hemoglobin,BMI and prevalence of diabetic complications in different groups.Results About 70.9%of the 4612 patients used hypoglycemic agents,34.8%used metformin,35.1%used sulfonylureas,22.9%used alpha glycosidase inhibitors,and 13.8%used insulin.The prevalence of diabetic nephropathy,retinopathy,neuropathy,stroke,and diabetic foot was higher in the combination than in the untreated and single-drug users(P<0.01).Only 41.3%subjects had HbA1C<7%.The fasting blood glucose and HbA1C values were lower in the untreated group than in other three medication groups,and the rate of the HbA1C reaching target in the untreated group was higher than the other medication groups(P<0.01).As the types of drug increased,HbA1C was less likely to reach the target(P<0.01).There were 42.2%of patients with BMI<24 kg/m2,and there was no significant difference in the proportion of BMI reaching target among the four groups(P>0.05).Conclusion The most common used antidiabetic drugs in diabetic patients in Shanghai are metformin,sulfonylureas,α-glycosides inbibitor,and insulin.The blood glucose control in diabetic patients in Shanghai community is not good enough.Patients with a longer duration of diabetes,a lower rate of HbA1C at goal,and a higher prevalence of diabetic complications may be more prone to use multiple hypoglycemic drugs.
作者
陈小曼
王宁荐
陈奕
朱春芳
曹晨昱
布阿提卡木·阿布都克日木
张雯
陆颖理
Chen Xiaoman;Wang Ningjian;Chen Yi;Zhu Chunfang;Cao Chenyu;Buatikamu Abudukerimu;Zhang Wen;Lu Yingli(Department of Endocrinology,the Ninth People′s Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200011,China)
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2019年第11期955-961,共7页
Chinese Journal of Endocrinology and Metabolism
基金
国家自然科学基金(81570726、91857117)。
关键词
HBA1C
空腹血糖
体重指数
降糖药
HbA1C
Fasting blood glucose
Body mass index
Antidiabetic drugs
