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老年人2型糖尿病的控制水平与多重用药、伴发的合并症以及根据Beers标准的各种风险增加相关。

Control Level of Type 2 Diabetes Mellitus in the Elderly Is Associated with Polypharmacy, Accompanied Comorbidities, and Various Increased Risks According to the Beers Criteria.

作者信息

Atak Tel Burcin Meryem, Aktas Gulali, Bilgin Satilmis, Baltaci Sumeyye Buse, Taslamacioglu Duman Tuba

机构信息

Department of Internal Medicine, Abant Izzet Baysal University Hospital, 14280 Bolu, Turkey.

出版信息

Diagnostics (Basel). 2023 Nov 13;13(22):3433. doi: 10.3390/diagnostics13223433.

Abstract

Comorbidity rates in the geriatric population have increased because of rising life expectancy; thus, patients have had to use more medications. Type 2 diabetes mellitus, one of the most common diseases, may influence the number of drugs used in geriatric patients. The present study was designed to investigate the association between the level of type 2 DM and polypharmacy. Fifty patients with type 2 diabetes over the age of 65 were included according to the inclusion criteria; 23 were well-controlled and 27 had poorly controlled diabetes. The groups were similar in terms of age, sex, WBC, Hb, Plt, AST, ALT, serum creatinine, fasting glucose, and eGFR levels. Patients with HbA1c values above 7.5 were classified as poorly controlled diabetes patients, and those below were considered well-controlled diabetes patients and were evaluated for inappropriate medication use. The number of medications used daily by the cases ( < 0.001), the number of concomitant diseases ( = 0.001), and the number of increased risks according to the Beers Criteria ( = 0.02) were observed to be high in poorly controlled type 2 diabetes mellitus subjects. HbA1c levels were related to the number of medications (r = 0.4, = 0.004), comorbidities (r = 0.28, = 0.04), and the number of increased risks according to the Beers Criteria (r = 0.31, = 0.014). In conclusion, the number of medications used in patients with poorly controlled type 2 diabetes mellitus was found to be more elevated than in individuals with well-controlled type 2 diabetes mellitus. The HbA1c values varied among patients regarding polypharmacy, comorbidities, and increased risks according to the Beers Criteria.

摘要

由于预期寿命的延长,老年人群中的合并症发生率有所上升;因此,患者不得不使用更多药物。2型糖尿病是最常见的疾病之一,可能会影响老年患者使用的药物数量。本研究旨在调查2型糖尿病水平与多重用药之间的关联。根据纳入标准,纳入了50名65岁以上的2型糖尿病患者;其中23名病情得到良好控制,27名糖尿病控制不佳。两组在年龄、性别、白细胞、血红蛋白、血小板、谷草转氨酶、谷丙转氨酶、血清肌酐、空腹血糖和估算肾小球滤过率水平方面相似。糖化血红蛋白(HbA1c)值高于7.5的患者被归类为糖尿病控制不佳患者,低于该值的患者被视为糖尿病控制良好患者,并对其不适当用药情况进行评估。观察发现,2型糖尿病控制不佳的受试者每日使用的药物数量(P<0.001)、合并疾病数量(P = 0.001)以及根据Beers标准增加的风险数量(P = 0.02)都很高。HbA1c水平与药物数量(r = 0.4,P = 0.004)、合并症(r = 0.28,P = 0.04)以及根据Beers标准增加的风险数量(r = 0.31,P = 0.014)相关。总之,发现2型糖尿病控制不佳患者使用的药物数量比2型糖尿病控制良好的个体更高。根据Beers标准,患者在多重用药、合并症和增加的风险方面,HbA1c值存在差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d634/10670184/87bd62a55449/diagnostics-13-03433-g001.jpg

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