Guillausseau Pierre-Jean
Service de médecine B, hôpital Lariboisière, 2 rue Ambroise Paré, 75010 Paris Université Paris 7.
Presse Med. 2004 Feb 14;33(3):156-60. doi: 10.1016/s0755-4982(04)98512-0.
To evaluate the impact of optimization of treatment and improvement in observance awareness in patients with type 2 diabetes on compliance with oral antidiabetic drug therapy and long-term glycemic control. Method Evaluation of compliance with oral antidiabetic therapy and of HbA1c levels in a cohort of 4 802 patients with type 2 diabetes followed by their general practitioner, before and after 6 Months on optimized treatment: reduction in percentage of combination treatments from 69.5 to 56.8%, and increase in percentage of once-daily dosing regimen from 12 to 58.4%.
Optimization of treatment led to an increase in the percentage of patients achieving optimal compliance with oral antidiabetic drug therapy from 44 to 69.5% after 6 Months (p<0.001). Metabolic control also improved, as evidenced by a decrease in HbA1c levels observed both in the whole cohort (7.5+/-1.6% to 6.9+/-1.2%; p<0.0005), as well as in individual therapeutic subgroups of patients (having switched from multiple-daily dosing to once-daily-dosing schedules and from gliclazide 80 to gliclazide 30 MR once-daily formulation).
These findings suggest that optimization of oral antidiabetic therapy favoring the use of oral antidiabetic agents with once-daily dosing administration modalities may improve metabolic control in patients with type 2 diabetes.
评估2型糖尿病患者治疗优化及服药依从性意识提高对口服降糖药物治疗依从性和长期血糖控制的影响。方法:对4802例2型糖尿病患者进行队列研究,由全科医生随访,评估优化治疗6个月前后口服降糖治疗的依从性及糖化血红蛋白(HbA1c)水平:联合治疗比例从69.5%降至56.8%,每日一次给药方案比例从12%增至58.4%。
治疗优化使口服降糖药物治疗达到最佳依从性的患者比例在6个月后从44%增至69.5%(p<0.001)。代谢控制也得到改善,整个队列的HbA1c水平下降(从7.5±1.6%降至6.9±1.2%;p<0.0005),各治疗亚组患者(从每日多次给药改为每日一次给药方案,以及从格列齐特80改为格列齐特30缓释片每日一次剂型)的HbA1c水平也下降。
这些研究结果表明,优化口服降糖治疗,采用每日一次给药方式的口服降糖药物,可能改善2型糖尿病患者的代谢控制。