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糖尿病患者样本中的代谢纠正:临床结果与成本降低

Metabolic Correction in Patients Sample with Diabetes: Clinical Outcomes and Costs Reductions.

作者信息

Miranda-Massari Jorge R, Rodríguez-Gómez José R, González Michael J, Cidre Carlos, Duconge Jorge, Marín Heriberto, Grace Kazuko, McLeod Howard L

机构信息

Dept. of Pharmacy Practice, School of Pharmacy, Medical Sciences Campus, UPR, San Juan, PR.

Metabolic Correction Institute, San Juan, PR.

出版信息

Int J Diabetes Res. 2016;5(5):92-101.

Abstract

Diabetes is a leading cause of mortality and morbidity worldwide. Diabetes complications produce profound impact on patient's quality of life and represent very significant economic cost to patients, their family, the government and society as a whole. Metabolic correction has been proposed as an efficient method to improve clinical outcomes and reduce costs in diabetes. Metabolic correction is a concept that supports health maintenance and promotes the healing processes by improving the body's biochemical-physiological mechanisms. This is done by helping activate the metabolic enzymes necessary to facilitate key physiological pathways. A group of 50 patients followed a simple metabolic correction strategy based on hydration, diet, and magnesium supplementation during a 6 months period. Outcomes measures included laboratory testing, anthropometric measures and medication use including its related costs. Patients had an average weight loss of 9.4 lbs (↓5.0%) from baseline at month 3 and 12 lbs (↓6.4%) at month 6. Waist circumference decreased on average 3.7 inches (↓9.0%) from baseline at month 3 and had further decrease to 5.5 inches (↓13.4%) from baseline at month 6. Laboratory testing of average triglycerides decreased from a baseline of 156.9 to 116.7 (↓25.6%) at month 3 and maintained a reduction of ↓24.2% by month 6. Total cholesterol concentration decreased from a baseline of 181.1 mg/dL to 173.9 (↓4.0%) in month 3 and to 171.1 (↓5.5%) at month 6. Average HgA1c decreased from baseline of 7.17 to 6.52 (↓9.1%) at month 3 and maintained 6.52 at months 6. The atherogenic index decreased from 4.18 at baseline to 3.85 at month 3 (↓7.9%) and then 3.47 (17.0%) at month 6. Medication use and cost was quantified in various ways. The average baseline monthly diabetes medication cost per patient of $124.10 was reduced to $ 78.23 (↓36.7% reduction) at month 3 and to $62.80 (↓49.4% reduction) at month 6. A simple and well structured metabolic correction program that includes a significant educational component, dietary modifications and dietary supplement intake was able to maintain or improve vital signs, anthopometric and laboratory measurements that correlate with improved clinical diabetes and cardiovascular health. This outcome was achieved while decreasing the use medications at month 3 and 6 at significant cost savings.

摘要

糖尿病是全球死亡率和发病率的主要原因。糖尿病并发症对患者的生活质量产生深远影响,给患者及其家庭、政府和整个社会带来了巨大的经济成本。代谢纠正已被提议作为改善糖尿病临床结局和降低成本的有效方法。代谢纠正是一个通过改善人体生化生理机制来支持健康维持和促进愈合过程的概念。这是通过帮助激活促进关键生理途径所需的代谢酶来实现的。一组50名患者在6个月期间遵循了基于补水、饮食和补充镁的简单代谢纠正策略。结果指标包括实验室检测、人体测量指标以及药物使用情况及其相关成本。患者在第3个月时体重较基线平均减轻了9.4磅(下降5.0%),在第6个月时减轻了12磅(下降6.4%)。腰围在第3个月时较基线平均减少了3.7英寸(下降9.0%),在第6个月时进一步降至较基线减少5.5英寸(下降13.4%)。平均甘油三酯的实验室检测值从基线的156.9降至第3个月时的116.7(下降25.6%),到第6个月时维持下降24.2%。总胆固醇浓度在第3个月时从基线的181.1毫克/分升降至173.9(下降4.0%),在第6个月时降至171.1(下降5.5%)。平均糖化血红蛋白(HgA1c)在第3个月时从基线的7.17降至6.52(下降9.1%),在第6个月时维持在6.52。致动脉粥样硬化指数从基线时的4.18降至第3个月时的3.85(下降7.9%),然后在第6个月时降至3.47(下降17.0%)。药物使用情况和成本通过多种方式进行了量化。每位患者每月糖尿病药物的平均基线成本为124.10美元,在第3个月降至78.23美元(下降36.7%),在第6个月降至62.80美元(下降49.4%)。一个简单且结构良好的代谢纠正计划,包括重要的教育内容、饮食调整和膳食补充剂摄入,能够维持或改善与糖尿病和心血管健康改善相关的生命体征、人体测量和实验室测量结果。在第3个月和第6个月减少药物使用并大幅节省成本的同时实现了这一结果。

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