Miyazawa Itsuko, Yokoyama Hiroki, Yagi Noriharu, Araki Shin-Ichi, Morino Katsutaro, Kume Shinji, Shirabe Shinichirou, Yamazaki Katsuya, Maegawa Hiroshi
Department of Medicine, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan; Education Center for Medicine and Nursing, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan.
Internal Medicine, Jiyugaoka Medical Clinic, Hokkaido Obihiro, Hokkaido 080-0016, Japan.
Diabetes Res Clin Pract. 2023 Apr;198:110599. doi: 10.1016/j.diabres.2023.110599. Epub 2023 Feb 26.
This study aimed to evaluate changes in glycemic control and diabetes treatment by age group in Japanese patients with type 2 diabetes.
The study included the results of approximately 40,000 patients/year using cross-sectional and retrospective analyses from 2012 to 2019.
There was little change in the glycemic control status in all age groups during the study period. However, by age group, patients aged ≤ 44 years continued to have the highest glycated hemoglobinA1c (HbA1c) values during the study period (7.4 % ± 1.7 % in 2012 and 7.4 % ± 1.5 % in 2019), especially in insulin-treated patients (8.3 % ± 1.9 % in 2012 and 8.4 % ± 1.8 % in 2019). Biguanides and dipeptidyl peptidase-4 inhibitors were widely prescribed. Sulfonylurea and insulin use showed a decreasing trend, but older patients had a higher percentage of prescriptions. Sodium glucose transporter 2 inhibitors were prescribed rapidly, especially in younger patients.
There were no obvious changes in glycemic control over time in the study period. The mean HbA1c level was higher in younger patients, which suggested that improvement is required. In older patients, there was a trend toward greater emphasis on management to avoid hypoglycemia. Different treatment strategies based on age showed different drug choices.
本研究旨在评估日本2型糖尿病患者血糖控制及糖尿病治疗随年龄组的变化情况。
该研究纳入了2012年至2019年约40000例患者/年的横断面和回顾性分析结果。
在研究期间，所有年龄组的血糖控制状况变化不大。然而，按年龄组划分，44岁及以下的患者在研究期间糖化血红蛋白A1c（HbA1c）值持续最高（2012年为7.4%±1.7%，2019年为7.4%±1.5%），尤其是接受胰岛素治疗的患者（2012年为8.3%±1.9%，2019年为8.4%±1.8%）。二甲双胍和二肽基肽酶-4抑制剂的处方广泛。磺脲类药物和胰岛素的使用呈下降趋势，但老年患者的处方比例更高。钠-葡萄糖协同转运蛋白2抑制剂的处方迅速增加，尤其是在年轻患者中。
在研究期间，血糖控制随时间没有明显变化。年轻患者的平均HbA1c水平较高，这表明需要改善。在老年患者中，有更加强调避免低血糖管理的趋势。基于年龄的不同治疗策略显示出不同的药物选择。
