Ito Hiroyuki, Tsugami Emiko, Ando Shigenori, Imai Ayano, Matsumoto Suzuko, Omoto Takashi, Shinozaki Masahiro, Nishio Shinya, Abe Mariko, Antoku Shinichi, Mifune Mizuo, Togane Michiko
Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, Tokyo, Japan.
Department of Pharmacy, Edogawa Hospital, Tokyo, Japan.
J Clin Med Res. 2016 Oct;8(10):710-4. doi: 10.14740/jocmr2610w. Epub 2016 Aug 30.
We investigated the trends in the clinical characteristics and prescriptions of type 2 diabetic patients with severe hypoglycemia because the prescription rate of antidiabetic agents has significantly changed recently.
A total of 193 patients with type 2 diabetes with severe hypoglycemia induced by antidiabetic agents between 2008 and 2013 were divided into three groups based on the period of visit: 2008 - 2009, 2010 - 2011 and 2012 - 2013.
While the proportion of patients with severe hypoglycemia using insulin (from 55% to 74%), biguanides (from 6% to 20%), glinides, and dipeptidyl peptidase-4 inhibitors significantly increased, those using sulfonylureas (from 45% to 20%) significantly decreased. Errors of drug use significantly increased as a trigger of hypoglycemia in recent years. The number of antidiabetic agents (from 1.9 ± 0.6 to 2.3 ± 0.7), non-diabetic agents (from 2.3 ± 2.4 to 4.3 ± 3.3), and total drugs prescribed were significantly higher in recent years among patients receiving insulin therapy.
Polypharmacy especially in patients receiving insulin therapy and errors of drug use have increased in type 2 diabetic patients with severe hypoglycemia in recent years. Intensive education in the usage rule of drugs is considered to be important in order to prevent severe hypoglycemia.
由于近年来抗糖尿病药物的处方率发生了显著变化,我们对严重低血糖的2型糖尿病患者的临床特征和处方趋势进行了调查。
将2008年至2013年间193例因抗糖尿病药物导致严重低血糖的2型糖尿病患者根据就诊时间分为三组:2008 - 2009年、2010 - 2011年和2012 - 2013年。
使用胰岛素(从55%升至74%)、双胍类药物(从6%升至20%)、格列奈类药物和二肽基肽酶 - 4抑制剂的严重低血糖患者比例显著增加,而使用磺脲类药物的患者比例(从45%降至20%)显著下降。近年来,作为低血糖诱因的用药错误显著增加。近年来,接受胰岛素治疗的患者中,抗糖尿病药物数量(从1.9±0.6增至2.3±0.7)、非糖尿病药物数量(从2.3±2.4增至4.3±3.3)和总处方药物数量显著更高。
近年来,严重低血糖的2型糖尿病患者中,尤其是接受胰岛素治疗的患者,联合用药和用药错误有所增加。为预防严重低血糖,强化药物使用规则教育被认为很重要。