The Japanese Medical and Dental Practitioners for the Improvement of Medical Care, Tokyo, Japan.
Endocr J. 2010;57(6):499-507. doi: 10.1507/endocrj.k09e-366. Epub 2010 Mar 6.
Sulfonylureas are commonly used for the treatment of patients with type 2 diabetes mellitus (T2DM). However, some clinical concerns regarding their use have grown over the past decade. Thus, results of a previous Japan-wide cross-sectional survey of patients with type 2 diabetes mellitus (T2DM) were analyzed to determine the present status and problems associated with the use of sulfonylureas in the treatment of T2DM by general practitioners (GPs) and diabetes specialists. Of 15,652 patients across 721 clinics and hospitals from the previous survey, 15,350 were diagnosed as T2DM (14,312 by GPs and 1,038 by specialists). For each patient, data were collected for HbA1c levels, age, height, body weight, and treatment modality. Of T2DM patients being treated by GPs, 35.4% and 60.0% received sulfonylureas in entire oral drugs or as monotherapy, respectively, compared with 29.2% and 61.2% of patients, respectively, treated by specialists. Of the patients treated with sulfonylurea monotherapy, 1335 patients (35.2%) achieved HbA1c <6.5%, whereas HbA1c was >or=8.0% in 531 patients (14.0%). Patients with HbA1c levels >or=8.0% had a higher body mass index, used glibenclamide more frequently, and used higher doses of sulfonylureas than patients in whom HbA1c levels were <6.5%. In conclusion, the present study shows that sulfonylureas are central in the treatment of T2DM in Japan. However, careful consideration of suitable patients, agents, and doses is necessary to achieve appropriate glycemic control.
磺酰脲类药物常用于治疗 2 型糖尿病（T2DM）患者。然而，在过去十年中，人们对其使用的一些临床问题越来越关注。因此，对之前一项针对 2 型糖尿病（T2DM）患者的日本全国横断面调查结果进行了分析，以确定基层医生（GP）和糖尿病专家在治疗 T2DM 中使用磺酰脲类药物的现状和存在的问题。在之前的调查中，从 721 家诊所和医院中抽取了 15652 名患者，其中 15350 名被诊断为 T2DM（GP 诊断 14312 例，专家诊断 1038 例）。对于每位患者，收集了 HbA1c 水平、年龄、身高、体重和治疗方式的数据。在接受 GP 治疗的 T2DM 患者中，分别有 35.4%和 60.0%的患者接受了磺酰脲类药物的全部口服药物或单药治疗，而在接受专家治疗的患者中，这一比例分别为 29.2%和 61.2%。在接受磺酰脲类药物单药治疗的患者中，有 1335 名（35.2%）患者的 HbA1c＜6.5%，而 531 名（14.0%）患者的 HbA1c≥8.0%。HbA1c≥8.0%的患者体重指数较高，更频繁使用格列本脲，使用的磺酰脲类药物剂量也高于 HbA1c＜6.5%的患者。总之，本研究表明磺酰脲类药物在日本 T2DM 的治疗中占据核心地位。然而，为了实现适当的血糖控制，有必要仔细考虑合适的患者、药物和剂量。
