Research group in Social Pharmacy, Department of Global Public Health and Primary Care, and Centre for Pharmacy, University of Bergen, Norway.
Research group in General Practice, Department of Global Public Health and Primary Care, University of Bergen, Norway; Noklus, Norwegian Quality Improvement of Primary Care Laboratories, Bergen, Norway.
Diabetes Res Clin Pract. 2014 Jul;105(1):102-9. doi: 10.1016/j.diabres.2014.04.012. Epub 2014 Apr 28.
Determine prevalence of diabetes, and describe use of blood glucose lowering (BGL) drugs and glycemic control in Norwegian nursing homes.
In this cross-sectional study we collected details of BGL drugs, capillary blood glucose measurements (CBGM) in the last four weeks and HbA1c measurements in the last 12 months from the medical records of patients with diabetes, within a population of 742 long-term care patients from 19 randomly selected nursing homes in Western Norway. Descriptive statistics were applied, and Pearson's chi-squared (P≤0.05) or non-overlapping 95% confidence intervals were interpreted as significant effects.
116 patients (16%) had diabetes, 100 of these gave informed consent and medical data were available. BGL treatment was as follows: (1) insulin only (32%), (2) insulin and oral antidiabetics (OADs) (15%), (3) OADs only (27%) and (4) no drugs (26%). Patients with cognitive impairment were less likely to receive medical treatment (P=0.04). CBGM and HbA1c measurements were performed for 73% and 77% of patients, respectively. Mean HbA1c was 7.3% (57 mmol/mol), 46% of patients had an HbA1c <7.0% (53 mmol/mol), and CBGM consistent with risk of hypoglycemia was found for 60% of these patients.
Prevalence of diabetes and BGL treatment in Norwegian nursing homes is comparable to other European countries. Although special care seems to be taken when choosing treatment for patients with cognitive impairment, there are signs of overtreatment in the population as a whole. The strict glycemic control unveiled may negatively affect these frail patients' quality of life and increase the risk of early death.
确定挪威养老院中糖尿病的患病率，并描述血糖降低药物的使用情况和血糖控制情况。
在这项横断面研究中，我们从挪威西部 19 家随机选择的养老院中 742 名长期护理患者的医疗记录中收集了糖尿病患者过去四周内的血糖药物、毛细血管血糖测量值（CBGM）以及过去 12 个月内的糖化血红蛋白测量值的详细信息。应用描述性统计，Pearson's 卡方检验（P≤0.05）或不重叠的 95%置信区间被解释为显著影响。
116 名患者（16%）患有糖尿病，其中 100 名患者知情同意并提供了医疗数据。血糖治疗如下：（1）仅胰岛素（32%），（2）胰岛素和口服降糖药（OADs）（15%），（3）仅 OADs（27%）和（4）无药物（26%）。有认知障碍的患者接受药物治疗的可能性较小（P=0.04）。分别有 73%和 77%的患者进行了 CBGM 和 HbA1c 测量。平均 HbA1c 为 7.3%（57mmol/mol），46%的患者 HbA1c<7.0%（53mmol/mol），其中 60%的患者 CBGM 提示有低血糖风险。
挪威养老院中糖尿病的患病率和血糖治疗与其他欧洲国家相当。尽管在为认知障碍患者选择治疗方案时似乎特别注意，但整个人群中存在过度治疗的迹象。所揭示的严格血糖控制可能会对这些脆弱患者的生活质量产生负面影响，并增加早期死亡的风险。
