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评估二甲双胍在基层医疗中对高危人群2型糖尿病预防的应用情况。

Evaluating the metformin use on type 2 diabetes prevention in high-risk populations in primary care.

作者信息

Álvarez-Villalobos Neri A, Ramírez-Torres Andony I, Ruiz-Hernández Fernando G, Omaña Gabriela G Elizondo, García-Hernández Rosa M, Peña Pablo J Moreno, Rojo-Garza Sandra S

机构信息

Department of Education, Family Medicine Unit Number 7, Instituto Mexicano del Seguro Social (IMSS), San Pedro Garza García, N.L., Mexico.

Department of Postgraduate Studies, Family Medicine, Universidad de Monterrey, Monterrey, Nuevo León, Mexico.

出版信息

J Family Med Prim Care. 2024 Nov;13(11):5002-5008. doi: 10.4103/jfmpc.jfmpc_552_24. Epub 2024 Nov 18.

Abstract

PURPOSE/BACKGROUND: To identify the proportion of patients with prediabetes who have prescribed metformin and factors related to doing so as a preventive measure for diabetes in primary care at a Family Medicine Unit in northeastern Mexico.

METHODS

This retrospective observational study included 372 adults who met the criteria for prediabetes diagnosis according to the American Diabetes Association. Data was collected from medical records from January 2020 to December 2021. Possible associations between the variables of interest and the prescription of metformin were tested via hypothesis tests, furthermore, binary logistic regression was performed.

RESULTS

Nearly 85% of the patients met at least one criterion for receiving metformin according to ADA recommendations, but only 60% of them were prescribed this medication. Patients with metformin prescriptions differed from those without in aspects such as having a documented diagnosis of prediabetes in their medical records, a higher BMI, and higher glucose levels.

CONCLUSIONS

Almost one out of two patients with a high risk of type 2 diabetes are not treated with metformin as a preventive measure. Factors associated with metformin prescription included a high BMI, elevated baseline glucose levels, and a prediabetes diagnosis in the medical record. These findings suggest the need for studies to evaluate physicians' reasons for different treatments and implementation of recommendations for type 2 diabetes prevention in patients with prediabetes in primary health care.

摘要

目的/背景:确定在墨西哥东北部一家家庭医学单位的初级保健中,接受二甲双胍处方的糖尿病前期患者比例以及与此相关的因素,以此作为糖尿病的预防措施。

方法

这项回顾性观察研究纳入了372名符合美国糖尿病协会糖尿病前期诊断标准的成年人。数据收集自2020年1月至2021年12月的医疗记录。通过假设检验对感兴趣的变量与二甲双胍处方之间的可能关联进行了测试,此外,还进行了二元逻辑回归分析。

结果

根据美国糖尿病协会的建议,近85%的患者符合至少一项接受二甲双胍治疗的标准,但其中只有60%的患者被开具了这种药物。开具二甲双胍处方的患者与未开具的患者在病历中有糖尿病前期的确诊记录、更高的体重指数和更高的血糖水平等方面存在差异。

结论

几乎每两名2型糖尿病高危患者中就有一名未接受二甲双胍作为预防措施的治疗。与二甲双胍处方相关的因素包括高体重指数、基线血糖水平升高以及病历中有糖尿病前期诊断。这些发现表明需要进行研究,以评估医生采取不同治疗方法的原因,并在初级卫生保健中对糖尿病前期患者实施2型糖尿病预防建议。

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