Drzewoski Jozef, Sawer-Szewczyk Joanna, Stepień Anna, Olszewski Andrzej, Liniarski Marek
Department of Diabetology and Clinical Pharmacology. Medical University of Lodz.
Pol Arch Med Wewn. 2005 Sep;114(3):862-7.
People with diabetes mellitus have higher risk of cardiovascular morbidity and mortality from thrombo-vascular complications than non-diabetics and it is recommended that they should use acetylsalicylic acid (ASA) as anitiplatelet agent regularly. The aim of this study was to examine current physician counseling about ASA therapy and the use of ASA by Polish patients with diabetes. The study involved 464 randomly selected Caucasian diabetic individuals, mainly with type 2 (>98%), who were asked to complete a questionnaire consisting of 16 questions while visiting out-patient medical centres for periodical examination or during hospitalization. We collected data on the prevalence of cardiovascular disease (CVD), frequency of risk factors among diabetic patients and on ASA physician counseling, and on the rate of regular ASA users among the patients. The most self-reported conditions were angina pectoris or prior myocardial infarction (63,6%). Current cigarette smoking was declared by 7,1% of the patients, elevated serum cholesterol levels by 58%, and hypertension by 62,9%. Majority of the patients were overweight, and family history of coronary artery disease (CAD) was reported by 30,2% of the patients. ASA was taken by 67,2% of all the patients and 72,1% of them had taken ASA regularly. The highest percentage (>80%) of regular ASA users was found among diabetic patients with CAD. A minority of the patients who reported stroke (43,9%) or claudication (15,8%) were taking ASA regularly. Number of the patients (32,8%) with CVD risk factor(s) but without diagnosed CVD did not use ASA at all. The majority of the patients (78%) were counseled by their physicians why they should use ASA regularly.
the number of regular users of ASA among diabetic patients in Poland with CVD others than CAD or among patients with at least two CAD risk factors is still unsatisfactory. Therefore, while it seems that there is a remarkable growing of ASA therapy world-wide more effort is needed to make this practice a standard of multifactorial, intensive diabetes treatment. Our results also suggest the need for more aggressive education of both doctors and patients.
糖尿病患者因血栓血管并发症导致心血管疾病发病率和死亡率高于非糖尿病患者,建议他们定期使用乙酰水杨酸(ASA)作为抗血小板药物。本研究的目的是调查波兰糖尿病患者目前关于ASA治疗的医生咨询情况以及ASA的使用情况。该研究纳入了464名随机选择的白种糖尿病患者,主要为2型糖尿病患者(>98%),他们在前往门诊医疗中心进行定期检查或住院期间被要求填写一份包含16个问题的问卷。我们收集了心血管疾病(CVD)的患病率、糖尿病患者中危险因素的频率、关于ASA的医生咨询情况以及患者中定期使用ASA的比例等数据。最常自我报告的疾病是心绞痛或既往心肌梗死(63.6%)。7.1%的患者报告目前吸烟,58%的患者血清胆固醇水平升高,62.9%的患者患有高血压。大多数患者超重,30.2%的患者报告有冠状动脉疾病(CAD)家族史。所有患者中有67.2%服用了ASA,其中72.1%的患者定期服用ASA。在患有CAD的糖尿病患者中,定期使用ASA的比例最高(>80%)。报告有中风(43.9%)或跛行(15.8%)的患者中,少数人定期服用ASA。有CVD危险因素但未诊断为CVD的患者中有32.8%根本未使用ASA。大多数患者(78%)得到了医生关于为何应定期使用ASA的咨询。
在波兰患有除CAD之外的CVD的糖尿病患者或至少有两个CAD危险因素的患者中,ASA的定期使用者数量仍不令人满意。因此,虽然全球范围内ASA治疗似乎有显著增加,但仍需要做出更多努力,使这种做法成为多因素强化糖尿病治疗的标准。我们的结果还表明需要对医生和患者进行更积极的教育。