Obeid Kawa Ahmad, Hamasaeed Ahmed Ghafour
Department of Clinical Pharmacy/ College of Pharmacy, University of Sulaimani, Sulaimani, Kurdistan Region, Iraq.
Diabetes Metab Syndr Obes. 2023 Jan 11;16:71-83. doi: 10.2147/DMSO.S388750. eCollection 2023.
The problem of polypharmacy and the nature of the disease make patients with type 2 diabetes mellitus highly vulnerable to drug therapy problems, especially those who are on insulin therapy. Despite this challenge, reaching the desired clinical outcome and using an appropriate insulin regimen are also considered a controversial issue among clinicians. The current study is designed to explore the impact of insulin staging regimens in the context of pharmaceutical care on patients with type 2 diabetes mellitus.
This study is a randomized interventional comparative study of a few groups. It was conducted at the Diabetes and Endocrine Centre in Sulaymaniyah City in Iraq from January to August 2022. Patients with T2DM who were on insulin therapy were enrolled in this trial. The participants were divided into two groups, the interventional and non-interventional groups. The insulin regimen was modified, and pharmaceutical care process was performed for the intervention group. Drug therapy problems (DTPs) and clinical parameters were monitored both groups over the course of six months.
A total of 67 patients with T2DM on insulin were included in this study, and of them, 73% were females, with a mean age of 57.34 ± 7.825 years. The groups were randomly divided into intervention and non-intervention groups. After six months of applying insulin staging in the context of pharmaceutical care, FPG (Mean Diff.= 72.25, 95% CI of diff.= 20.44 to 124.1), HbA1c (Mean Diff.= 2.087, 95% CI of diff.= 1.151 to 3.023) and DTP were significantly improved in the intervention group.
Implementing the insulin staging approach within the context of the pharmaceutical care process showed a significant impact on controlling plasma glucose levels.
多重用药问题以及疾病的性质使得2型糖尿病患者极易出现药物治疗问题，尤其是那些接受胰岛素治疗的患者。尽管存在这一挑战，但实现理想的临床结局以及采用合适的胰岛素治疗方案在临床医生中仍是一个有争议的问题。本研究旨在探讨药学服务背景下胰岛素分阶段治疗方案对2型糖尿病患者的影响。
本研究为几组间的随机干预对比研究。于2022年1月至8月在伊拉克苏莱曼尼亚市的糖尿病与内分泌中心开展。接受胰岛素治疗的2型糖尿病患者纳入本试验。参与者被分为两组，即干预组和非干预组。对干预组修改胰岛素治疗方案并实施药学服务流程。在六个月的时间里对两组的药物治疗问题（DTPs）和临床参数进行监测。
本研究共纳入67例接受胰岛素治疗的2型糖尿病患者，其中73%为女性，平均年龄为57.34±7.825岁。这些组被随机分为干预组和非干预组。在药学服务背景下应用胰岛素分阶段治疗六个月后，干预组的空腹血糖（平均差值 = 72.25，差值的95%置信区间 = 20.44至124.1）、糖化血红蛋白（平均差值 = 2.087，差值的95%置信区间 = 1.151至3.023）和药物治疗问题均有显著改善。
在药学服务流程中实施胰岛素分阶段治疗方法对控制血糖水平有显著影响。
