Paquot N
Service de Diabétologie, Nutrition et Maladies Métaboliques, CHU de Liège, Belgique.
Rev Med Liege. 2010 May-Jun;65(5-6):326-31.
The treatment of diabetes mellitus is complex and involves lifestyle modification to optimize nutrition and physical activity as well as the addition of pharmacological therapy to provide needed physiological support for insulin deficiency or for insulin resistance. Adherence to medical recommendations has been found to be associated with improved glycaemic control through HbA1c reduction but also to result in improved outcomes and reduced costs of diabetes. Despite this potential benefit of pharmacological therapy, adherence to glucose-lowering treatments is poor, ranging from 36% to 85% adherence to oral medications. The most common factors affecting medication taking in diabetic patients include regimen complexity, dosing frequency greater than twice daily, cost, poor self-confidence, insufficient education about the use of the products, depression, and adverse effects or fear of them. Several barriers to medication taking have been suggested although well-controlled trials to confirm and resolve these barriers are limited yet. Further studies are needed to test specific interventions to improve medication taking in diabetes.
糖尿病的治疗很复杂,包括改变生活方式以优化营养和身体活动,以及添加药物治疗,为胰岛素缺乏或胰岛素抵抗提供所需的生理支持。已发现坚持医学建议与通过降低糖化血红蛋白改善血糖控制相关,还能改善糖尿病的治疗结果并降低成本。尽管药物治疗有这种潜在益处,但降糖治疗的依从性很差,口服药物的依从性在36%至85%之间。影响糖尿病患者服药的最常见因素包括治疗方案复杂、每日给药次数超过两次、费用、自信心不足、对产品使用的教育不足、抑郁以及不良反应或对不良反应的恐惧。尽管证实和解决这些障碍的对照试验有限,但已提出了几种服药障碍。需要进一步研究来测试改善糖尿病患者服药的具体干预措施。