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[2型糖尿病治疗中胰岛素治疗依从性不佳]

[Therapeutic non-compliance with insulin in the treatment of diabetes mellitus 2].

作者信息

Márquez Contreras Emilio, Martell Claros Nieves, Gil Guillén Vicente, Casado Martínez José Joaquín, Martín de Pablos José Luis, Ferraro García Javier, Chaves González Rosa, Fernández Ortega Amalia

机构信息

Unidad de Gestión Clínica La Orden, Huelva, España.

出版信息

Aten Primaria. 2012 Feb;44(2):74-81. doi: 10.1016/j.aprim.2010.11.013. Epub 2011 Oct 22.

Abstract

OBJECTIVE

To determine the percentage of therapeutic noncompliance among type 2 diabetes patients on treatment with insulin.

DESIGN

Prospective multicentre study.

SETTING

Nine Primary Care Health Centre in Huelva (Spain).

PARTICIPANTS

A total of 121 type 2 diabetics, who, in the opinion of their doctor, need to start treatment with insulin or have their insulin treatment modified.

MAIN MEASUREMENTS

Five visits were made (enrolment, 6, 12, 18 and 24 months). The variables analysed were, fasting blood glucose, glycosylated haemoglobin, compliance with insulin treatment, measured by counting insulin units. The percentage compliance (PC) was calculated by (PC = Total No. of insulin units expected to be consumed / Total No. of insulin units that should have been taken x 100). A complier was considered as one who achieved a PC between 80 and 100%.

RESULTS

There were 103 evaluable subjects (85.8%) with a mean age of 66.4 (SD 11.6) years, and 45 were male (42.8%). The mean percentage compliance with insulin was 90.9% (95% CI, 84.2-97.6%). At the 6, 12, 18 and 24 months visits it was 92.1% (95% CI, 85.6-98.6%), 92.3, 90.1 and 89.2% (95% CI, 81.7-96.7%), respectively. Overall patient compliance was 74.75% (95% CI, 64.3-85.2%). For the visits, compliance was 82.5% (95% CI, 73.3-91.7%), 77.7%, 73.8% and 71.8% (95% CI, 60.9-82.7%), respectively (P<.05 initial-final).

CONCLUSIONS

A quarter of the diabetic patients did not comply with their insulin treatment.

摘要

目的

确定接受胰岛素治疗的2型糖尿病患者中治疗不依从的百分比。

设计

前瞻性多中心研究。

地点

西班牙韦尔瓦的9家初级保健健康中心。

参与者

共有121名2型糖尿病患者,在其医生看来,他们需要开始胰岛素治疗或调整胰岛素治疗方案。

主要测量指标

进行了5次访视(入组时、6个月、12个月、18个月和24个月)。分析的变量包括空腹血糖、糖化血红蛋白、胰岛素治疗依从性(通过计算胰岛素单位来衡量)。依从率(PC)的计算方法为(PC = 预期消耗的胰岛素单位总数 / 应服用的胰岛素单位总数×100)。依从者被定义为依从率在80%至100%之间的患者。

结果

有103名可评估的受试者(85.8%),平均年龄为66.4岁(标准差11.6),其中45名男性(42.8%)。胰岛素的平均依从率为90.9%(95%可信区间,84.2 - 97.6%)。在6个月、12个月、18个月和24个月访视时,依从率分别为92.1%(95%可信区间,85.6 - 98.6%)、92.3%、90.1%和89.2%(95%可信区间,81.7 - 96.7%)。总体患者依从性为74.75%(95%可信区间,64.3 - 85.2%)。对于各次访视,依从性分别为82.5%(95%可信区间,73.3 - 91.7%)、77.7%、73.8%和71.8%(95%可信区间,60.9 - 82.7%)(初始 - 最终,P <.05)。

结论

四分之一的糖尿病患者未遵守胰岛素治疗方案。

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