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基层医疗中糖尿病与肥胖患者的处理方法。

Approach to patients with diabetes and obesity in primary care.

机构信息

Unidad de Gestión Clínica San Andres-Torcal Clinical, Distrito Málaga-Guadalhorce, Málaga, Spain.

Programa de Doctorado en Biomedicina, Investigación Traslacional, y Nuevas Tecnologías en Salud, Facultad de Medicina, Universidad de Málaga, Málaga, Spain.

出版信息

Aten Primaria. 2024 Feb;56(2):102807. doi: 10.1016/j.aprim.2023.102807. Epub 2023 Nov 14.

Abstract

AIMS

The aim of this study is to analyse the effect of pharmacological and non-pharmacological treatment on weight control in patients with diabetes and obesity.

DESIGN

Epidemiological, descriptive, cross-sectional study. SITE: Primary care. In 11 health centres in Málaga and Cádiz during April and October 2022.

PARTICIPANTS

281 patients over 18 years old with type 2 diabetes and obesity are included.

MAIN MEASUREMENTS

Socio-demographics, clinical, treatment and lifestyle habits variables were obtained from medical records and personal interview. Descriptive statistics were obtained for continuous variables. Statistical tests were performed based on the nature of the variables.

RESULTS

Variables like marital status, level of education and occupation, and smoking habit, shows differences regarding the sex (p<0.05). 82.3% of those who received education lost weight, compared to 67.5% of lost weight who received no health education (p=0.004). GLP1 and SGLT2 were more commonly prescribed for women (p=0.048), and SGLT2 more commonly prescribed for men (p=0.047). Patients taking GLP1, SGLT2 or both, regardless of sex, weight loss during the study period was -3.1kg (SE: 0.60), while the loss of those who took other medications was -1.33kg (SE: 0.62). The mean difference was 1.75kg (p=0.046).

CONCLUSIONS

In terms of weight loss, obese diabetics who took GLP1, SGLT2 or both were 2.5 times more likely to lose weight than those who did not. Healthy lifestyle choices are key to weight loss in obese diabetic patients.

摘要

目的

本研究旨在分析药物和非药物治疗对糖尿病和肥胖患者体重控制的影响。

设计

流行病学、描述性、横断面研究。地点:初级保健。在 2022 年 4 月至 10 月期间,在马拉加和加的斯的 11 个卫生中心进行。

参与者

纳入 281 名年龄在 18 岁以上的 2 型糖尿病合并肥胖患者。

主要测量

从病历和个人访谈中获得社会人口统计学、临床、治疗和生活方式习惯变量。对连续变量进行描述性统计。根据变量的性质进行统计检验。

结果

婚姻状况、教育水平和职业以及吸烟习惯等变量在性别上存在差异(p<0.05)。接受教育的人中有 82.3%体重减轻,而未接受健康教育的人中有 67.5%体重减轻(p=0.004)。GLP1 和 SGLT2 更常被女性开处方(p=0.048),而 SGLT2 更常被男性开处方(p=0.047)。无论性别如何,服用 GLP1、SGLT2 或两者的患者在研究期间体重减轻了-3.1kg(SE:0.60),而服用其他药物的患者体重减轻了-1.33kg(SE:0.62)。平均差异为 1.75kg(p=0.046)。

结论

就体重减轻而言,服用 GLP1、SGLT2 或两者的肥胖糖尿病患者体重减轻的可能性是未服用的患者的 2.5 倍。健康的生活方式选择是肥胖糖尿病患者体重减轻的关键。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/358c/10684366/120bca261709/gr1.jpg

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