希腊最优 2 型糖尿病管理包括基准测试和标准治疗研究的理由、设计和基线患者特征。

Rationale, design and baseline patient characteristics of the optimal type 2 diabetes management including benchmarking and standard treatment study in Greece.

机构信息

Michael S Kostapanos, Vasilis Tsimihodimos, Moses S Elisaf, Department of Internal Medicine, School of Medicine, University of Ioannina, 45110 Ioannina, Greece.

出版信息

World J Diabetes. 2014 Feb 15;5(1):76-83. doi: 10.4239/wjd.v5.i1.76.

DOI:10.4239/wjd.v5.i1.76

PMID:24567804

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3932430/

Abstract

AIM

To describe baseline data of the optimal type 2 diabetes management including benchmarking and standard treatment (OPTIMISE) study in Greece.

METHODS

"Benchmarking" is the process of receiving feedback comparing one's performance with that of others. The OPTIMISE (NCT00681850) study is a multinational, multicenter study assessing, at a primary care level, whether using "benchmarking" can help to improve the quality of patient care, compared with a set of guideline-based reference values ("non-benchmarking"). In the Greek region, 797 outpatients (457 men, mean age 63.8 years) with type 2 diabetes were enrolled by 84 office-based physicians. Baseline characteristics of this population are presented.

RESULTS

Hypertension was the most prevalent concomitant disorder (77.3%) and coronary heart disease was the most frequent macrovascular complication of diabetes (23.8%). Most patients were overweight or obese (body mass index 29.6 ± 5 kg/m(2)), exhibiting mostly abdominal obesity (waist circumference 102.6 ± 13.6 cm). Biguanides were the most prevalent prescribed drugs for the management of diabetes (70.1% of all prescriptions), whereas statins (93.5% of all prescriptions) and angiotensin receptor blockers (55.8% of all prescriptions) were the most prevalent prescribed drugs for hyperlipidemia and hypertension, respectively. Only 37.4% of patients were on aspirin. Despite treatment, pre-defined targets for fasting plasma glucose (< 110 mg/dL), glycated hemoglobin (< 7%), systolic blood pressure (< 130 mmHg and < 125 mmHg for patients with proteinuria) and low density lipoprotein cholesterol levels (< 100 mg/dL and < 70 mg/dL for patients with coronary heart disease) were reached in a relatively small proportion of patients (29%, 53%, 27% and 31%, respectively). In a Greek population with type 2 diabetes, the control of glycemia or concomitant disorders which increase cardiovascular risk remains poor.

CONCLUSION

Despite relevant treatment, there is a poor control of diabetes, hypertension and hyperlipidemia in Greek outpatients with type 2 diabetes.

摘要

目的

描述包括基准测试和标准治疗（OPTIMISE）研究在内的 2 型糖尿病最佳管理的基线数据，该研究在希腊进行。

方法

“基准测试”是指接收将自身表现与他人表现进行比较的反馈的过程。OPTIMISE（NCT00681850）研究是一项多中心、多国研究，旨在评估在初级保健水平上，使用“基准测试”是否可以帮助改善患者护理质量，与一套基于指南的参考值（“非基准测试”）相比。在希腊地区，由 84 名门诊医生招募了 797 名 2 型糖尿病门诊患者（457 名男性，平均年龄 63.8 岁）。本研究介绍了该人群的基线特征。

结果

高血压是最常见的合并症（77.3%），糖尿病最常见的大血管并发症是冠心病（23.8%）。大多数患者超重或肥胖（体重指数 29.6 ± 5kg/m²），表现出明显的腹部肥胖（腰围 102.6 ± 13.6cm）。二甲双胍是治疗糖尿病最常用的药物（所有处方的 70.1%），而他汀类药物（所有处方的 93.5%）和血管紧张素受体阻滞剂（所有处方的 55.8%）是治疗高血脂和高血压最常用的药物。只有 37.4%的患者服用阿司匹林。尽管进行了治疗，但空腹血糖（<110mg/dL）、糖化血红蛋白（<7%）、收缩压（<130mmHg 和<125mmHg 合并蛋白尿患者）和低密度脂蛋白胆固醇水平（<100mg/dL 和<70mg/dL 合并冠心病患者）的预设目标仍仅在相对较小比例的患者中达到（分别为 29%、53%、27%和 31%）。在希腊 2 型糖尿病患者中，血糖控制或增加心血管风险的合并症控制仍然不佳。