Shaw Kenneth M
Academic Department of Diabetes and Endocrinology, Queen Alexandra Hospital Cosham, Portsmouth, PO6 3LY, UK.
Metabolism. 2006 May;55(5 Suppl 1):S6-9. doi: 10.1016/j.metabol.2006.02.001.
Several factors influence diabetes control, and many of these can adversely affect endeavors to obtain optimal glycemic management. For many patients with type 2 diabetes mellitus, the passage of time often results in a loss of responsiveness to medication and a greater difficulty in achieving desired target levels. Although these observations in part reflect a natural progression of diabetes, irrespective of treatment given, it is possible to identify modifiable hurdles that can be addressed with better outcome results. Lifestyle measures, particularly diet and exercise, remain paramount, whereas other secondary confounding factors such as systemic or endocrine disease or other conflicting medication need specific therapeutic attention. Most patients with type 2 diabetes mellitus will require oral hypoglycemic medication and this should be prescribed in the simplest, most effective, and safest way. Ensuring that patients fully understand treatment objectives is important resulting in better compliance with advised treatment. Such compliance can be significantly improved by keeping treatment regimens simple. With its novel once-daily formulation, gliclazide modified release has been shown to improve adherence to medication and result in better glycemic outcome as determined by improved HbA(1c) levels. Its benefits in terms of reduced risk of hypoglycemia have been demonstrated in the GlUcose control In type 2 diabetes: Diamicron modified release versus glimEpiride study.
有几个因素会影响糖尿病的控制，其中许多因素会对实现最佳血糖管理的努力产生不利影响。对于许多2型糖尿病患者来说，随着时间的推移，往往会出现对药物反应性丧失以及更难达到理想目标水平的情况。尽管这些观察结果部分反映了糖尿病的自然进展，无论给予何种治疗，但有可能识别出可改变的障碍，并通过更好的结果来解决。生活方式措施，特别是饮食和运动，仍然至关重要，而其他次要混杂因素，如全身性或内分泌疾病或其他相互冲突的药物，则需要特定的治疗关注。大多数2型糖尿病患者需要口服降糖药，应以最简单、最有效和最安全的方式开处方。确保患者充分理解治疗目标很重要，这会导致更好地遵守建议的治疗。通过保持治疗方案简单，可以显著提高这种依从性。格列齐特缓释片采用新颖的每日一次剂型，已被证明可提高药物依从性，并根据糖化血红蛋白（HbA1c）水平的改善导致更好的血糖结果。在2型糖尿病血糖控制研究：格列齐特缓释片与格列美脲对比研究中，已证明其在降低低血糖风险方面的益处。
