根据主要临床实践指南，老年 2 型糖尿病患者血糖控制的适宜性存在较大差异。
Large discrepancy in glycaemic control appropriateness in geriatric patients with type 2 diabetes according to major clinical practice guidelines.
机构信息
Fund for Scientific Research - FNRS, Brussels, Belgium.
Clinical Pharmacy Research Group, Louvain Drug Research Institute (LDRI), Université catholique de Louvain, Brussels, Belgium.
出版信息
Eur Geriatr Med. 2022 Jun;13(3):753-758. doi: 10.1007/s41999-021-00594-1. Epub 2021 Nov 25.
PURPOSE
In geriatric patients with type 2 diabetes (T2D), appropriate glycaemic control is crucial to avoid overtreatment and hypoglycaemia. This study compared glycaemic control appropriateness across three major clinical practice guidelines (CPGs).
METHODS
Retrospective study of geriatric older inpatients with T2D and glucose-lowering treatment before admission. Patients were classified as appropriately treated, overtreated or undertreated using CPGs from Diabetes Canada 2018 (DC18), the Endocrine Society 2019 (ES19) and the American Diabetes Association 2021 (ADA21).
RESULTS
Of the 318 geriatric patients (median age 84 years, 54% women, 66% in poor health), 46%, 25% and 82% were appropriately treated, while 38%, 57% and 0% were overtreated, based on DC18, ES19 and ADA21, respectively.
CONCLUSION
Large discrepancy of glycaemic control appropriateness was detected across these CPGs and concerned mainly overtreatment. This finding relates to the absence in ADA21 of a lower HbA1c value, which may be an obstacle to the prevention of hypoglycaemia.
目的
在患有 2 型糖尿病（T2D）的老年患者中，适当的血糖控制对于避免过度治疗和低血糖至关重要。本研究比较了三项主要临床实践指南（CPG）在血糖控制适宜性方面的差异。
方法
回顾性研究了患有 T2D 的老年住院患者和入院前的降糖治疗。使用加拿大 2018 年糖尿病指南（DC18）、2019 年内分泌学会指南（ES19）和 2021 年美国糖尿病协会指南（ADA21），将患者分为适当治疗、过度治疗或治疗不足。
结果
在 318 名老年患者（中位年龄 84 岁，54%为女性，66%健康状况不佳）中，根据 DC18、ES19 和 ADA21，分别有 46%、25%和 82%的患者得到了适当治疗，而分别有 38%、57%和 0%的患者被过度治疗。
结论
这些 CPG 之间存在很大的血糖控制适宜性差异，主要与过度治疗有关。这一发现与 ADA21 缺乏较低的 HbA1c 值有关，这可能是预防低血糖的障碍。
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