Graduate Program in Sciences Applied to Adult Health Care, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Centro de Ciências da Saúde, Universidade Federal de São João Del-Rei, São João Del-Rei, Brazil.
Pharmacoepidemiol Drug Saf. 2021 Jun;30(6):749-757. doi: 10.1002/pds.5236. Epub 2021 Apr 3.
To determine whether desirable diabetes control is associated with polypharmacy and to evaluate potential drug interactions (DI) in participants with diabetes mellitus in the Brazilian Longitudinal Study on Adult Health (ELSA-Brasil).
This cross-sectional study included 1418 participants with medical diagnosis of diabetes at study baseline (2008-2010). Polypharmacy was defined as the use of ≥5 drugs. We described the frequency of the most common pharmacological groups used by patients and the potential DI.The association between desirable diabetes control (normal A1c, blood pressure and lipid levels) and polypharmacy was investigated using logistic regression.
Most participants were men (52.5%), mean age 57.6 (SD 8.4) years, educated to the university level (39.4%), and self-reported as white (42.9%). In this study, 7.1% (n = 101) of participants had desirable control of diabetes, while 40.4% (n = 573) used polypharmacy, and this use was not significantly associated with better diabetes control (adjusted odds ratio (OR = 1.35 [95%CI 0.86-2.13] P = .19).The pharmacological groups most frequently used were oral antidiabetics followed by acetylsalicylic acid, angiotensin-converting enzyme inhibitors (ACE inhibitors) and statins.The prevalence of potentially mild, moderate and severe DI were, respectively, 2.5%, 14.7% and 0.9%; however, in the desirable control of DM group, these potential DI were related to comorbidity control.
Faced with the importance of achieving optimal control of diabetes and minimizing risks of potential DI, these results, which are in keeping with previous findings described in the literature, might indicate that guidelines for the patient-centered management of control of diabetes must be revised.
确定糖尿病控制是否与多种药物治疗有关，并评估巴西纵向成人健康研究（ELSA-Brasil）中患有糖尿病的参与者中潜在的药物相互作用（DI）。
本横断面研究纳入了基线（2008-2010 年）有糖尿病医学诊断的 1418 名参与者。多种药物治疗定义为使用≥5 种药物。我们描述了患者最常用的药理学药物的使用频率以及潜在的药物相互作用。使用逻辑回归研究了理想的糖尿病控制（正常糖化血红蛋白、血压和血脂水平）与多种药物治疗之间的关联。
大多数参与者为男性（52.5%），平均年龄为 57.6（8.4）岁，接受过大学教育（39.4%），自报为白人（42.9%）。在这项研究中，7.1%（n=101）的参与者糖尿病控制理想，而 40.4%（n=573）使用了多种药物治疗，但这种治疗与更好的糖尿病控制无显著相关性（调整后的优势比（OR）=1.35[95%CI 0.86-2.13]，P=0.19）。最常使用的药物组为口服抗糖尿病药物，其次为乙酰水杨酸、血管紧张素转换酶抑制剂（ACE 抑制剂）和他汀类药物。潜在的轻度、中度和重度药物相互作用的发生率分别为 2.5%、14.7%和 0.9%；然而，在糖尿病控制理想的组中，这些潜在的药物相互作用与合并症控制有关。
鉴于实现糖尿病最佳控制和最小化潜在药物相互作用风险的重要性，这些结果与文献中描述的先前发现一致，可能表明必须修订以患者为中心的糖尿病控制管理指南。
