Department of Endocrinology & Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
Jiangsu Medical Quality Control Center (Endocrinology and Metabolism), Nanjing, 210008, China.
Sci China Life Sci. 2018 Mar;61(3):318-327. doi: 10.1007/s11427-017-9052-4. Epub 2017 May 17.
The qualification of physicians is a key factor in controlling type 1 diabetes (T1D) since they provide crucial information to their patients about self-management. To investigate whether Chinese physicians' medical strategies influence the control of T1D in their patients, we designed a questionnaire to survey Chinese physicians, which covered their diagnosis and patient-management strategies for T1D. A total of 442 completed questionnaires were received from 35 public hospitals in 12 cities. The results showed Chinese physicians mainly diagnosed T1D based on the clinical features and islet dysfunction. One-third of physicians in this study still prescribed non-basal-bolus insulin regimens to their T1D patients. More than 80% of the doctors prescribed alpha-glucosidase inhibitors as adjunctive therapy, in addition to insulin therapy. Moreover, most of the physicians in China did not pay attention to identify coexistent autoimmune diseases. T1D patients in China were not armed with self-management knowledge and skills, which should be provided by their doctors. One of the circumstances leading to insufficient disease control in Chinese T1D patients is the ineffective therapeutic strategy prescribed by their physicians. We need to promote knowledge of efficient strategies among physicians in China to achieve better disease control in Chinese T1D patients in the future.
医生的资质是控制 1 型糖尿病(T1D)的关键因素,因为他们向患者提供有关自我管理的重要信息。为了研究中国医生的医疗策略是否会影响其患者的 T1D 控制,我们设计了一份问卷来调查中国医生,其中包括他们对 T1D 的诊断和患者管理策略。我们共收到来自 12 个城市 35 家公立医院的 442 份完整问卷。结果表明,中国医生主要根据临床特征和胰岛功能障碍来诊断 T1D。研究中有三分之一的医生仍为 T1D 患者开非基础-餐时胰岛素方案。超过 80%的医生除了胰岛素治疗外,还会开α-葡萄糖苷酶抑制剂作为辅助治疗。此外,中国的大多数医生并不关注是否同时存在自身免疫性疾病。中国的 T1D 患者没有掌握自我管理的知识和技能,而这些本应由他们的医生提供。中国 T1D 患者的疾病控制不佳的一个原因是他们的医生开出的治疗方案效果不佳。我们需要在中国医生中推广有效的治疗策略知识,以实现未来中国 T1D 患者更好的疾病控制。