Chaudhry Sarwat I, Berlowitz Dan R, Concato John
Clinical Epidemiology Research Center, Department of Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut 06520, USA.
J Am Geriatr Soc. 2005 Jul;53(7):1214-6. doi: 10.1111/j.1532-5415.2005.53370.x.
To examine the influence of age and comorbidity on intensification of medical therapy for patients with poorly controlled diabetes mellitus (DM).
Observational cohort study using data from Department of Veterans Affairs (VA) national databases.
Thirteen VA medical centers in New England, Florida, and Puerto Rico.
Veterans (N=5,317) with poorly controlled DM receiving regular medical care
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.
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).
Rates of intensification at a single clinic visit were quite low in all groups and were lowest in older patients with comorbidity.
探讨年龄和合并症对糖尿病控制不佳患者强化药物治疗的影响。
利用退伍军人事务部（VA）国家数据库的数据进行观察性队列研究。
新英格兰、佛罗里达和波多黎各的13家VA医疗中心。
接受常规医疗护理的糖尿病控制不佳的退伍军人（N = 5317）
如果开始使用新的降糖药物或增加现有药物的剂量，则在此次就诊时视为降糖药物增加或治疗强化。
治疗强化的总体发生率为20.8%（1106/5317）。在无合并症的最年轻患者中强化率最高（24.5%），在有合并症的最年长患者中强化率最低（15.7%）（P<0.001）。
所有组在单次就诊时的强化率都相当低，在有合并症的老年患者中最低。
