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使用口服降糖药的2型糖尿病患者治疗满意度的相关因素:日本市区的一项横断面研究

Factors associated with treatment satisfaction in patients with type 2 diabetes mellitus using oral glucose-lowering agents: a cross-sectional study in urban districts in Japan.

作者信息

Hayashi Isao, Watanabe Nobuaki, Nakata Shinsuke, Komatsu Ryoya, Motoda Saori, Fujita Yukari, Ishibashi Chisaki, Yamaguchi Baden Megu, Kimura Takekazu, Takahara Mitsuyoshi, Kozawa Junji, Imagawa Akihisa, Iwahashi Hiromi, Shimomura Iichiro

机构信息

Hayashi Clinic, Nishinomiya, Hyogo, Japan.

Watanabe Clinic, Nishinomiya, Hyogo, Japan.

出版信息

Endocr J. 2018 Oct 29;65(10):1001-1009. doi: 10.1507/endocrj.EJ18-0182. Epub 2018 Jul 20.

DOI:10.1507/endocrj.EJ18-0182
PMID:30033945
Abstract

Various oral glucose-lowering agents are available in Japan. Although the objective characteristics of these drugs are well described, little is known about treatment satisfaction by patients using these agents. The aim of this study was to assess treatment satisfaction of diabetic patients visiting diabetes clinics using the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and to determine the association of the DTSQ scores with various factors including oral glucose-lowering agents. The study subjects were 754 outpatients who had been treated with one or more oral glucose-lowering agents, but not insulin or glucagon-like peptide-1 receptor agonist. The collected data included the response to DTSQ as completed by the patients, various parameters pertaining diabetes treatment including adherence, motivation, life style, social support, complications and cost burden from the patients and attending physicians. The associations among satisfaction scores and various parameters were analyzed by multiple linear regression analysis. In all subjects, use of sodium-glucose cotransporter 2 inhibitor (SGLT2i) were positively, and irregular diet time were negatively associated with satisfaction scores significantly as well as some factors which had been previously reported to be associated. Subgroup analysis showed that adherence to diet and use of SGLT2i were positively in obese (body mass index ≥25 kg/m), and HbA1c and irregular work time were negatively in non-obese (<25 kg/m) patients associated with satisfaction scores. These results suggest that SGLT2i is really used with high satisfaction, especially by obese patients and that factors associated with treatment satisfaction might differ between obese and non-obese patients using oral glucose-lowering agents.

摘要

日本有多种口服降糖药。虽然这些药物的客观特性已有详尽描述,但对于使用这些药物的患者的治疗满意度却知之甚少。本研究的目的是使用糖尿病治疗满意度问卷(DTSQ)评估就诊于糖尿病诊所的糖尿病患者的治疗满意度,并确定DTSQ得分与包括口服降糖药在内的各种因素之间的关联。研究对象为754名接受过一种或多种口服降糖药治疗,但未使用胰岛素或胰高血糖素样肽-1受体激动剂的门诊患者。收集的数据包括患者填写的DTSQ的回答,以及与糖尿病治疗相关的各种参数,包括患者和主治医生提供的依从性、动机、生活方式、社会支持、并发症和费用负担等。通过多元线性回归分析来分析满意度得分与各种参数之间的关联。在所有受试者中,使用钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)与满意度得分呈正相关,饮食时间不规律与满意度得分呈负相关,以及一些先前报道的相关因素也是如此。亚组分析显示,在肥胖(体重指数≥25kg/m²)患者中,饮食依从性和SGLT2i的使用与满意度得分呈正相关,而在非肥胖(<25kg/m²)患者中,糖化血红蛋白(HbA1c)和工作时间不规律与满意度得分呈负相关。这些结果表明,SGLT2i的实际使用满意度较高,尤其是肥胖患者,并且使用口服降糖药的肥胖和非肥胖患者中与治疗满意度相关的因素可能有所不同。

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