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2型糖尿病患者中二甲双胍治疗的禁忌证

Contraindications to metformin therapy among patients with type 2 diabetes mellitus.

作者信息

Sweileh Waleed M

机构信息

Clinical Pharmacology, College of Pharmacy, Clinical Pharmacy Graduate Program, An-Najah National University, P.O. Box 7,707, Nablus, Palestine.

出版信息

Pharm World Sci. 2007 Dec;29(6):587-92. doi: 10.1007/s11096-007-9095-1. Epub 2007 Feb 27.

Abstract

OBJECTIVE

The biguanide, metformin, is a commonly prescribed oral antihyperglycemic agent. However, there are several clinical conditions that are considered as contraindications to the use of metformin among patients with type 2 diabetes mellitus. The aim of this study was to investigate the presence and nature of contraindications to metformin therapy among patients with type 2 diabetes mellitus.

METHOD

A retrospective study of the medical files of diabetic patients available at Alwosta clinic, north Palestine was carried out. Information about disease and medication profile of the patients was retrieved and analyzed using SPSS during the study period in 2004/2005. Focus was on metformin users who have contraindications to metfromin therapy.

MAIN OUTCOME MEASURE

Presence and number of contraindications to metformin therapy.

RESULTS

Two hundred and seventy-two type 2 diabetic patients were identified. One hundred and twenty four of those diabetic patients were metformin users. Approximately, 60% of patients in the metformin group had a least one contraindication. Congestive heart failure and renal impairment were the most quantitatively present contraindications.

CONCLUSION

Contraindications to metformin therapy are common among type 2 diabetic patients and mostly disregarded. Patients have to be critically assessed before starting therapy and in case of metformin prescribing; dose should be adjusted based on the presence of risk factors for metformin adverse effects.

摘要

目的

双胍类药物二甲双胍是一种常用的口服降糖药。然而,在2型糖尿病患者中,有几种临床情况被视为使用二甲双胍的禁忌证。本研究的目的是调查2型糖尿病患者中二甲双胍治疗禁忌证的存在情况及性质。

方法

对巴勒斯坦北部Alwosta诊所的糖尿病患者病历进行回顾性研究。在2004/2005年的研究期间,使用SPSS检索并分析了患者的疾病和用药情况信息。重点关注有二甲双胍治疗禁忌证的二甲双胍使用者。

主要观察指标

二甲双胍治疗禁忌证的存在情况及数量。

结果

共识别出272例2型糖尿病患者。其中124例糖尿病患者使用二甲双胍。在二甲双胍组中,约60%的患者至少有一项禁忌证。充血性心力衰竭和肾功能损害是数量上最常见的禁忌证。

结论

二甲双胍治疗的禁忌证在2型糖尿病患者中很常见,且大多被忽视。在开始治疗前以及开具二甲双胍处方时,必须对患者进行严格评估;应根据存在二甲双胍不良反应的危险因素调整剂量。

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