由家庭医生随访的2型糖尿病患者：治疗顺序及体重和糖化血红蛋白随时间的变化

Type 2 diabetics followed up by family physicians: Treatment sequences and changes over time in weight and glycated hemoglobin.

作者信息

Boullenger Léna, Quindroit Paul, Legrand Bertrand, Balcaen Thibaut, Calafiore Matthieu, Rochoy Michaël, Beuscart Jean-Baptiste, Chazard Emmanuel

机构信息

Univ. Lille, CHU Lille, ULR 2694, METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, General Practice, F-59000 Lille, France.

Univ. Lille, CHU Lille, ULR 2694, METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, F-59000 Lille, France.

出版信息

Prim Care Diabetes. 2022 Oct;16(5):670-676. doi: 10.1016/j.pcd.2022.07.002. Epub 2022 Jul 19.

DOI:10.1016/j.pcd.2022.07.002

PMID:35864077

Abstract

INTRODUCTION

The treatment of type 2 diabetes mellitus (T2DM) is based on preventive hygiene and dietary measures (HDM), oral antidiabetic drugs (OADs), and insulin. The objective of the present study was to reuse general practice data from electronic health records and describe changes over time among patients with T2DM in primary care.

METHODS

We analyzed data on patients with T2DM collected by three family physicians in Tourcoing (France) from 2006 to 2018.

RESULTS

403 patients, 1030 treatment sequences, 39,042 appointments, 2440 glycated hemoglobin (HbA1c) measurements, and 9722 wt measurements were included. On inclusion, the mean age was 57.0, the mean weight was 84.4 kg, the mean body mass index was 30.3 kg/m, and the median HbA1c level was 6.8 % (51 mmol/mol). The patients were following appropriate HDM (40.7 %) and/or were being treated with OADs (54.1 %) or insulin (5.2 %). The median length of follow-up was 3.51 years. Overall, bodyweight was stable for two years during HDM and then increased. The HbA1c level decreased and then increased during HDM, was stable on OADs, and then decreased on insulin.

DISCUSSION/CONCLUSION: The present descriptive results may be of value in helping to predict changes over time in bodyweight and HbA1c in T2DM.

摘要

引言

2型糖尿病（T2DM）的治疗基于预防保健和饮食措施（HDM）、口服抗糖尿病药物（OADs）以及胰岛素。本研究的目的是重新利用电子健康记录中的全科医疗数据，并描述基层医疗中T2DM患者随时间的变化情况。

方法

我们分析了法国图尔宽的三名家庭医生在2006年至2018年期间收集的T2DM患者数据。

结果

纳入了403名患者、1030个治疗序列、39042次预约、2440次糖化血红蛋白（HbA1c）测量以及9722次体重测量。纳入时，平均年龄为57.0岁，平均体重为84.4千克，平均体重指数为30.3千克/平方米，HbA1c水平中位数为6.8%（51毫摩尔/摩尔）。患者遵循适当的HDM（40.7%）和/或接受OADs治疗（54.1%）或胰岛素治疗（5.2%）。随访的中位数时长为3.51年。总体而言，在HDM期间体重在两年内保持稳定，然后增加。HbA1c水平在HDM期间先下降后上升，在OADs治疗时保持稳定，在胰岛素治疗时则下降。

讨论/结论：目前的描述性结果可能有助于预测T2DM患者体重和HbA1c随时间的变化。