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亚洲糖尿病患者的基线特征、血糖控制和口服抗糖尿病药物治疗评估:糖尿病管理中评估口服降糖药使用情况(REASON)亚洲研究。

Assessment of baseline characteristics, glycemic control and oral antidiabetic treatment in Asian patients with diabetes: The Registry for Assessing OAD Usage in Diabetes Management (REASON) Asia study.

机构信息

Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

出版信息

J Diabetes. 2013 Sep;5(3):309-18. doi: 10.1111/1753-0407.12038. Epub 2013 May 28.

Abstract

BACKGROUND

To assess baseline characteristics, glycemic control, and treatment with oral antidiabetic drugs (OAD) in type 2 diabetes mellitus (T2DM) patients.

METHODS

This multinational, observational study recruited patients ≥ 21 years of age who were newly diagnosed and/or treated with OAD monotherapy for <6 months but were inadequately controlled. In cross-sectional phase, data on demographics, medical history, diabetic complications and comorbidities, OAD treatment, glycosylated hemoglobin (HbA1c), and fasting blood glucose (FBG) were collected. In longitudinal phase evaluating 6-month follow-up of sulfonylurea (SU)-treated patients, additional data on reasons for not achieving HbA1c targets were collected.

RESULTS

Of 1487 patients (mean [± SD] age 52.0 ± 11.6 years; 46.7% men; mean BMI 25.8 ± 4.4 kg/m(2) ) recruited, 75.9% were newly diagnosed, 73.3% had central obesity, 43.8% had hypertension, and 60.5% had dyslipidemia. The mean HbA1c was 9.8 ± 2.4%, and the mean FBG was 11.3 ± 4.3 mmol/L. At T0 (baseline) and T6 (month 6 visit), 99.8% (n=1066) and 97.1% (n=830) patients received SU, respectively. There was decrease from T0 to T6 in mean HbA1c (10.2% vs 7.3%, respectively; P<0.0001) and mean FBG (12.0 vs 7.6 mmol/L, respectively; P<0.0001). Number of patients with HbA1c <7% increased from T0 (4.5%) to T6 (46.8%). Reasons for not achieving target HbA1c included poor diabetes education (50.7%), non-compliance to OADs (21.4%), and fear of hypoglycemia (19.7%).

CONCLUSION

Marked reductions in HbA1c and FBG are achievable in T2DM patients managed with OADs. However, patient education and compliance are important for achieving and maintaining treatment targets.

摘要

背景

评估 2 型糖尿病(T2DM)患者的基线特征、血糖控制和口服抗糖尿病药物(OAD)治疗情况。

方法

这项多中心观察性研究招募了年龄≥ 21 岁的新诊断和/或接受 OAD 单药治疗<6 个月但控制不佳的患者。在横断面阶段,收集了患者的人口统计学、病史、糖尿病并发症和合并症、OAD 治疗、糖化血红蛋白(HbA1c)和空腹血糖(FBG)等数据。在评估磺酰脲(SU)治疗患者 6 个月随访的纵向阶段,还收集了未达到 HbA1c 目标的原因的额外数据。

结果

在纳入的 1487 例患者(平均[± SD]年龄 52.0±11.6 岁;46.7%为男性;平均 BMI 25.8±4.4 kg/m2)中,75.9%为新诊断,73.3%有中心性肥胖,43.8%有高血压,60.5%有血脂异常。平均 HbA1c 为 9.8±2.4%,平均 FBG 为 11.3±4.3 mmol/L。在 T0(基线)和 T6(第 6 个月就诊时)时,分别有 99.8%(n=1066)和 97.1%(n=830)的患者接受了 SU 治疗。与 T0 相比,HbA1c(分别为 10.2%和 7.3%;P<0.0001)和 FBG(分别为 12.0 和 7.6 mmol/L;P<0.0001)均值在 T6 时均下降。HbA1c<7%的患者比例从 T0(4.5%)增加到 T6(46.8%)。未达到目标 HbA1c 的原因包括糖尿病教育差(50.7%)、不遵守 OAD 治疗(21.4%)和担心低血糖(19.7%)。

结论

在接受 OAD 治疗的 T2DM 患者中,HbA1c 和 FBG 显著降低是可行的。然而,患者教育和依从性对于实现和维持治疗目标很重要。

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