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探讨 1 型糖尿病出院患者非胰岛素药物处方的影响因素。

Exploring the influencing factors of non-insulin drug prescriptions in discharged patients with type 1 diabetes.

机构信息

The First Clinical Institute, Zunyi Medical University, Zunyi, China.

Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.

出版信息

Front Endocrinol (Lausanne). 2024 Sep 25;15:1381248. doi: 10.3389/fendo.2024.1381248. eCollection 2024.

Abstract

OBJECTIVE

The aim of this study was to evaluate the admission indicators and characteristics of individuals diagnosed with type 1 diabetes (T1D) to ascertain potential impact on the choice of glucose control therapy after discharge.

METHODS

A total of 398 eligible T1D patients were selected. We conducted multivariable logistic regression analysis to determine the independent influence of predictors on the selection of glucose control therapy after discharge. To explore the influencing factors of different subgroups, we additionally performed subgroup analyses based on gender and age.

RESULTS

Our study revealed that body mass index (BMI) was noteworthy influence factor for prescription of insulin and non-insulin antidiabetic drug (NIAD prescription) in T1D patients of general population [OR = 1.109 (1.033-1.195), = 0.006], male [OR = 1.166 (1.040-1.318), = 0.011] and individuals below the age of 30 years [OR = 1.146 (1.020-1.301), = 0.028]. Diastolic blood pressure (DBP) was a protective factor for NIAD prescription in the general population [OR = 0.971 (0.949-0.992), = 0.008] and women [OR = 0.955 (0.923-0.988), = 0.008]. The other risk factor of NIAD prescription in men was dyslipidemia [OR = 4.824 (1.442-22.246), = 0.020]. Pulse pressure [OR = 1.036 (1.007-1.068), = 0.016] constituted an additional risk factor of NIAD prescription among individuals below the age of 30 years. The risk factors of NIAD prescription for people aged 30 to 50 years were length of stay [OR = 1.097 (1.014-1.196), = 0.026] and initial blood glucose [OR = 1.078 (1.007-1.168),  = 0.047]. In the case of individuals aged above 50 years, physicians exhibited a higher tendency to prescribe supplementary non-insulin medications to men [OR = 9.385 (1.501-87.789), = 0.029].

CONCLUSIONS

We identified notable factors that influence discharge prescriptions in patients with T1D. In order to enhance the treatment outcome for the patient, clinicians ought to have a special focus on these indicators or factors.

摘要

目的

本研究旨在评估诊断为 1 型糖尿病(T1D)患者的入院指标和特征,以确定这些指标和特征对出院后血糖控制治疗选择的潜在影响。

方法

共纳入 398 例符合条件的 T1D 患者。我们进行了多变量逻辑回归分析,以确定预测因子对出院后血糖控制治疗选择的独立影响。为了探讨不同亚组的影响因素,我们还根据性别和年龄进行了亚组分析。

结果

我们的研究表明,体质指数(BMI)是 T1D 普通人群胰岛素和非胰岛素降糖药物(NIAD 处方)处方的显著影响因素[比值比(OR)=1.109(1.033-1.195), = 0.006]、男性[OR=1.166(1.040-1.318), = 0.011]和 30 岁以下人群[OR=1.146(1.020-1.301), = 0.028]。舒张压(DBP)是普通人群和女性(OR=0.971(0.949-0.992), = 0.008)NIAD 处方的保护因素。男性中 NIAD 处方的另一个危险因素是血脂异常[OR=4.824(1.442-22.246), = 0.020]。脉压[OR=1.036(1.007-1.068), = 0.016]是 30 岁以下人群中 NIAD 处方的另一个危险因素。30 至 50 岁人群中 NIAD 处方的危险因素是住院时间[OR=1.097(1.014-1.196), = 0.026]和初始血糖[OR=1.078(1.007-1.168), = 0.047]。对于年龄大于 50 岁的人群,医生更倾向于给男性开具额外的非胰岛素药物[OR=9.385(1.501-87.789), = 0.029]。

结论

我们确定了影响 T1D 患者出院医嘱的显著因素。为了提高患者的治疗效果,临床医生应该特别关注这些指标或因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f87/11467696/acf5ac26e691/fendo-15-1381248-g001.jpg

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