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中东欧初级保健医生设定的2型糖尿病患者的治疗目标。

Treatment targets in patients with type 2 diabetes set by primary care physicians from Central and Eastern Europe.

作者信息

Tomasik Tomasz, Windak Adam, Seifert Bohumil, Kersnik Janko, Jozwiak Jacek

机构信息

Department of Family Medicine, Chair of Internal Medicine and Gerontology, Jagiellonian University Medical College , Krakow , Poland.

出版信息

Eur J Gen Pract. 2014 Dec;20(4):253-9. doi: 10.3109/13814788.2013.877130. Epub 2014 Feb 13.

Abstract

BACKGROUND

Primary care physicians have an important role in the care of patients with Type 2 diabetes but little is known about this issue in Central and Eastern European countries.

OBJECTIVES

To investigate the treatment goals of patients with type 2 diabetes mellitus (type 2 DM) set by primary care physicians in Central and Eastern European countries and illustrate inter-country variation.

METHODS

A cross-sectional survey of primary care physicians randomly chosen in nine countries. A validated questionnaire was used. Physicians reported treatment goals for patients with type 2 DM.

RESULTS

A total of 44.1% of physicians, reported the acceptance of HbA1c < 6.5% (48 mmol/mol) as a treatment goal, whilst 40% chose lower levels (< 6.1%; 43 mmol/mol). In all countries, 62% of physicians set FPG at a level of < 6.0 mmol/l. Most respondents set low BP levels as a goal of therapy (47% of physicians in all countries: BP < 130/80 mmHg and 48% < 120/80 mmHg). A TC level < 4.5 mmol/l and a LDL-C level < 2.5 mmol/l were reported as the targets for patients with diabetes by 51% and 69% of all respondents, respectively. The overall differences between all the countries were statistically significant (P < 0.01).

CONCLUSION

For patients with diabetes approximately half of physicians set treatment goals at levels that were recommended within the international guidelines. Most of them set treatment goals for HbA1c and BP at very low levels. Educational efforts to raise awareness about new treatment goals are needed.

摘要

背景

基层医疗医生在2型糖尿病患者的护理中发挥着重要作用,但在中欧和东欧国家,人们对这一问题了解甚少。

目的

调查中欧和东欧国家基层医疗医生为2型糖尿病(2型DM)患者设定的治疗目标,并说明国家间的差异。

方法

对九个国家随机选取的基层医疗医生进行横断面调查。使用经过验证的问卷。医生报告了2型DM患者的治疗目标。

结果

共有44.1%的医生报告接受糖化血红蛋白(HbA1c)<6.5%(48 mmol/mol)作为治疗目标,而40%的医生选择更低水平(<6.1%;43 mmol/mol)。在所有国家,62%的医生将空腹血糖(FPG)设定为<6.0 mmol/l。大多数受访者将低血压水平设定为治疗目标(所有国家47%的医生:血压<130/80 mmHg,48%<120/80 mmHg)。所有受访者中,分别有51%和69%报告将总胆固醇(TC)水平<4.5 mmol/l和低密度脂蛋白胆固醇(LDL-C)水平<2.5 mmol/l作为糖尿病患者的治疗目标。所有国家之间的总体差异具有统计学意义(P<0.01)。

结论

对于糖尿病患者,约一半的医生将治疗目标设定在国际指南推荐的水平。他们中的大多数将HbA1c和血压的治疗目标设定得非常低。需要开展教育工作,以提高对新治疗目标的认识。

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