Pérez Antonio, Franch Josep, Cases Aleix, González Juanatey José Ramón, Conthe Pedro, Gimeno Eva, Matali Arantxa
Servicio de Endocrinología y Nutrición, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
Med Clin (Barc). 2012 May 5;138(12):505-11. doi: 10.1016/j.medcli.2011.06.026. Epub 2011 Nov 25.
To evaluate the relationship between the degree of glycemic control and the features of the disease and glucose-lowering treatment in patients with type 2 diabetes mellitus in Spain.
Cross-sectional epidemiological study in Spain with consecutive sampling. We recorded demographic and clinical variables of patients who were followed up in the center for >12 months.
We analyzed data from 6,801 patients enrolled by 734 specialist and 965 primary care physicians: 97.8% received pharmacological treatment (30.3% monotherapy, 51,4% dual therapy, 16.1% triple therapy and 26.6% insulin). HbA(1c) was 7.3 (1.2) % and 40.4% of patients had HbA(1c)<7.0%. This proportion varied (P<.0001) according to the duration of diabetes (51.8% with <5 years, 39.6% with 5-10 years, 35.1% with 10-15 years and 31 4%>15 years) and the type of treatment (52.9% monotherapy, 35.6% dual therapy, 28.0% triple therapy and 25.2% insulin). In the multivariate analysis, insulin therapy (odds ratio [OR] 0.329; IC(95%) 0,267-0,405) and the presence of components of metabolic syndrome (hypertriglyceridemia and/or low HDL and/or abdominal obesity (OR 0.728; IC(95%) 0,595-0,890) were associated with poor glycemic control.
We observed an impairment of glycemic control with the progression of the disease and the complexity of the process and treatment, which in part may be related to the inadequate treatment selection and intensification.
评估西班牙2型糖尿病患者的血糖控制程度与疾病特征及降糖治疗之间的关系。
在西班牙进行的横断面流行病学研究，采用连续抽样。我们记录了在该中心随访超过12个月的患者的人口统计学和临床变量。
我们分析了由734名专科医生和965名初级保健医生纳入的6801例患者的数据：97.8%接受了药物治疗（30.3%为单药治疗，51.4%为双药治疗，16.1%为三联治疗，26.6%为胰岛素治疗）。糖化血红蛋白（HbA1c）为7.3（1.2）%，40.4%的患者HbA1c<7.0%。这一比例因糖尿病病程（病程<5年者为51.8%，5 - 10年者为39.6%，10 - 15年者为35.1%，>15年者为31.4%）和治疗类型（单药治疗为52.9%，双药治疗为35.6%，三联治疗为28.0%，胰岛素治疗为25.2%）而异（P<0.0001）。在多变量分析中，胰岛素治疗（比值比[OR] 0.329；95%置信区间[CI] 0.267 - 0.405）以及代谢综合征组分（高甘油三酯血症和/或低高密度脂蛋白和/或腹型肥胖，OR 0.728；95%CI 0.595 - 0.890）与血糖控制不佳相关。
我们观察到随着疾病进展以及治疗过程和治疗的复杂性增加，血糖控制出现损害，这部分可能与治疗选择不当和强化不足有关。
