Mirghani Hyder, Aljohani Samar, Albalawi Afaf
Internal Medicine, University of Tabuk, Tabuk, SAU.
Family Medicine, University of Tabuk, Tabuk, SAU.
Cureus. 2021 Apr 21;13(4):e14611. doi: 10.7759/cureus.14611.
Introduction Diabetes mellitus (DM) and dementia (DN) are common morbid disorders with high mortality, the two disorders shared the pathogenesis of proinflammation and insulin resistance. Polypharmacy is expected when DM and DN co-exist and medication adherence is essential to an effective self-care and management plan. This meta-analysis aimed to assess medication persistence among patients with diabetes and cognitive impairment (CogImp). Methods We systematically searched the literature through PubMed, Medline, Cochrane library, and the first 100 articles published in Google Scholar. We included articles publishes in English and conducted on humans, no limitation was set to the date of publication, all the articles were approached from the first published up to March 15, 2021. The keywords used were Dementia, cognitive impairment, cognitive decline, cognitive dysfunction, diabetes self-care, compliance to anti-diabetic drugs, and medication adherence. One hundred-seventy-six were identified, the 12 full texts screened, only four fulfilled the inclusion and exclusion criteria. Results The studies were published in Europe, the United States, and Asia (all were observational). The results showed no effects of dementia on medication adherence, P-value of 0.41, odd ratio: 1.09, 95% CI: 0.89-1.32, Chi-square for heterogeneity: 12.15, I= 75%, and standard difference = 3. The P-value for heterogeneity was 0.007. The studies included 2,556 patients and 1,854 events. Conclusion No association was found between dementia and compliance to anti-diabetic medications. Further prospective studies are needed to solve the issue.
引言 糖尿病（DM）和痴呆症（DN）是常见的高死亡率疾病，这两种疾病具有促炎和胰岛素抵抗的共同发病机制。当糖尿病和痴呆症共存时，往往需要联合用药，而药物依从性对于有效的自我护理和管理计划至关重要。本荟萃分析旨在评估糖尿病和认知障碍（CogImp）患者的药物持续性。方法 我们通过PubMed、Medline、Cochrane图书馆以及谷歌学术搜索的前100篇文章系统地检索了文献。我们纳入了以英文发表且针对人类的文章，对发表日期没有限制，所有文章均从首次发表直至2021年3月15日进行检索。使用的关键词有痴呆症、认知障碍、认知衰退、认知功能障碍、糖尿病自我护理、抗糖尿病药物依从性和药物持续性。共识别出176篇文章，筛选了12篇全文，只有4篇符合纳入和排除标准。结果 这些研究发表于欧洲、美国和亚洲（均为观察性研究）。结果显示痴呆症对药物依从性没有影响，P值为0.41，比值比为1.09，95%置信区间为0.89 - 1.32，异质性卡方值为12.15，I² = 75%，标准差为3。异质性的P值为0.007。这些研究纳入了2556名患者和1854个事件。结论 未发现痴呆症与抗糖尿病药物依从性之间存在关联。需要进一步的前瞻性研究来解决这个问题。
