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英格兰和威尔士因血糖异常导致的住院情况及抗糖尿病药物处方:一项生态学研究。

Hospital Admissions due to Dysglycaemia and Prescriptions of Antidiabetic Medications in England and Wales: An Ecological Study.

作者信息

Naser Abdallah Y, Wang Qian, Wong Lisa Y L, Ilomaki Jenni, Bell J Simon, Fang Gang, Wong Ian C K, Wei Li

机构信息

Research Department of Practice and Policy, UCL School of Pharmacy, London, UK.

Beijing Tongren Eye Center, Capital Medical University, Beijing, China.

出版信息

Diabetes Ther. 2018 Feb;9(1):153-163. doi: 10.1007/s13300-017-0349-1. Epub 2017 Dec 19.

Abstract

INTRODUCTION

Hypoglycaemia and hyperglycaemia are common adverse events associated with antidiabetic medications. They are also a common cause of hospital admissions for people with diabetes. The objective of the study was to explore the trends in hospital admissions due to hypoglycaemia and hyperglycaemia and in the prescriptions of antidiabetic medications in England and Wales.

METHODS

We conducted an observational study during the period 1999-2016. Hospital admission data for patients from all age groups were extracted from the Hospital Episode Statistics database in England and the Patient Episode Database for Wales. Data on prescriptions of antidiabetic medications were extracted from the Prescription Cost Analysis database from 2004 to 2016.

RESULTS

Between 1999 and 2016, the hospital admission rate increased by 173.0% [from 17.2 (95% CI 16.9-17.6) to 47.1 (95% CI 46.5-47.6) per 100,000 persons] for hypoglycaemia and by 147.0% [from 22.8 (95% CI 22.4-23.2) to 56.3 (95% CI 55.7-56.9) per 100,000 persons] for hyperglycaemia. The prescription rate for all antidiabetic medications increased between 2004 and 2016 by 116.0% [from 373.0 (95% CI 373.0-373.0) to 806.0 (95% CI 806.0-806.0) prescriptions per 1000 persons]. There was a parallel increase in the rate of antidiabetic medication prescriptions during the same study period, with correlation coefficients of 0.94 for hypoglycaemia and 0.98 for hyperglycaemia, respectively.

CONCLUSIONS

There have been parallel increases in the rate of admissions due to dysglycaemia and the rate of antidiabetic prescriptions in England and Wales. Further analytical studies are required to investigate whether increased admission for dysglycaemia is associated with increased use of antidiabetic medications.

摘要

引言

低血糖和高血糖是与抗糖尿病药物相关的常见不良事件。它们也是糖尿病患者住院的常见原因。本研究的目的是探讨英格兰和威尔士因低血糖和高血糖导致的住院趋势以及抗糖尿病药物的处方情况。

方法

我们在1999年至2016年期间进行了一项观察性研究。所有年龄组患者的住院数据从英格兰的医院事件统计数据库和威尔士的患者事件数据库中提取。抗糖尿病药物处方数据从2004年至2016年的处方成本分析数据库中提取。

结果

1999年至2016年期间,低血糖导致的住院率增加了173.0%[从每10万人中17.2例(95%可信区间16.9 - 17.6)增至47.1例(95%可信区间46.5 - 47.6)],高血糖导致的住院率增加了147.0%[从每10万人中22.8例(95%可信区间22.4 - 23.2)增至56.3例(95%可信区间55.7 - 56.9)]。2004年至2016年期间,所有抗糖尿病药物的处方率增加了116.0%[从每1000人中373.0例(95%可信区间373.0 - 373.0)增至806.0例(95%可信区间806.0 - 806.0)]。在同一研究期间,抗糖尿病药物处方率呈平行上升,低血糖的相关系数为0.94,高血糖的相关系数为0.98。

结论

在英格兰和威尔士,血糖异常导致的住院率和抗糖尿病药物处方率呈平行上升。需要进一步的分析研究来调查血糖异常住院率的增加是否与抗糖尿病药物使用的增加有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c74/5801235/4e38821d04b3/13300_2017_349_Fig1_HTML.jpg

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