阿片类药物使用障碍与 2 型糖尿病：参加丁丙诺啡-纳洛酮替代治疗方案对血糖控制的影响。
Opioid use disorder and type 2 diabetes mellitus: Effect of participation in buprenorphine-naloxone substitution programs on glycemic control.
机构信息
Physician practising in Sioux Lookout, Ont.
Health Director of Webequie First Nation in Ontario.
出版信息
Can Fam Physician. 2017 Jul;63(7):e350-e354.
OBJECTIVE
To measure the effect of buprenorphine-naloxone as opioid substitution therapy on glycemic control in patients with type 2 diabetes mellitus and opioid use disorder.
DESIGN
Retrospective cohort study and secondary data analysis.
SETTING
Northwestern Ontario.
PARTICIPANTS
Patients with diabetes receiving opioid substitution therapy, as well as patients with diabetes only, who live in 6 remote First Nations communities.
MAIN OUTCOME MEASURES
Glycated hemoglobin A values during a 2-year time period in the 2 groups.
RESULTS
Over a 2-year period, there was an absolute decrease of 1.20% in mean glycated hemoglobin A values in patients with diabetes who also received opioid substitution therapy, compared with patients with diabetes who were not being treated for opioid dependence, whose values rose by 0.02%.
CONCLUSION
Patients with diabetes who also suffer from opioid use disorder achieve significant ( = .011) improvement in glycemic control when treated with buprenorphine-naloxone substitution therapy compared with other patients with diabetes. Treating opioid use disorder with buprenorphine-naloxone substitution therapy has an unintended positive effect on diabetes management.
目的
评估丁丙诺啡-纳洛酮作为阿片类药物替代疗法对患有 2 型糖尿病和阿片类药物使用障碍患者的血糖控制的影响。
设计
回顾性队列研究和二次数据分析。
地点
安大略省西北部。
参与者
接受阿片类药物替代疗法的糖尿病患者，以及仅患有糖尿病、居住在 6 个偏远的第一民族社区的患者。
主要观察指标
两组患者在 2 年时间内糖化血红蛋白 A 值的变化。
结果
在 2 年期间，同时接受阿片类药物替代疗法的糖尿病患者的糖化血红蛋白 A 值平均下降了 1.20%，而未接受阿片类药物依赖治疗的糖尿病患者的糖化血红蛋白 A 值则上升了 0.02%。
结论
与其他患有糖尿病的患者相比，接受丁丙诺啡-纳洛酮替代疗法治疗的同时患有糖尿病和阿片类药物使用障碍的患者，其血糖控制有显著改善（=0.011）。用丁丙诺啡-纳洛酮替代疗法治疗阿片类药物使用障碍对糖尿病管理有意外的积极影响。
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