2型糖尿病患者的血糖和体重控制：一项基层医疗中的真实世界观察性研究。
Glycemic and weight control in people with type 2 diabetes: A real-world observational study in primary care.
作者信息
Orozco-Beltran D, Mata-Cases M, Artola-Menéndez S, Álvarez-Guisasola F, Cebrián-Cuenca A M, Pérez A
机构信息
Spanish Diabetes Society, Primary Care working group, Spain; Clinical Medicine Department, School of Medicine, Miguel Hernández University, Ctra. Nacional N-332 s/n, San Juan de Alicante 03550, Spain; Primary Care Research Center, Miguel Hernandez University, San Juan de Alicante, Spain; Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain.
Spanish Diabetes Society, Primary Care working group, Spain; DAP-Cat group, Research Support Unit Barcelona, Foundation University Institute for Primary Health Care Research Jordi Gol y Gurina (IDIAPJGol), Barcelona, Spain; Biomedical Research Networking Center in Diabetes and Associated Metabolic Disorders (CIBERDEM), Carlos III Health Institute (ISCIII), Barcelona, Spain.
出版信息
Prim Care Diabetes. 2025 Feb;19(1):7-14. doi: 10.1016/j.pcd.2024.12.002. Epub 2024 Dec 31.
AIMS
To analyze glycemic and bodyweight control in people with type 2 diabetes mellitus (T2DM), and prescribing patterns in primary care.
METHODS
We reviewed the electronic medical records of 5009 randomly selected T2DM patients, from 70 health centers in Spain. We analyzed results by age group and presence/absence of obesity. All data were collected in 2022.
RESULTS
Regarding treatment, 13.2 % of the sample were on lifestyle therapy only, 76.5 % received metformin, 37.6 % SGLT2 inhibitors, 32.2 % DPP-4 inhibitors, 12.2 % GLP-1 agonists, 18.9 % insulin, 6.5 % sulfonylureas, and 1.3 % glitazones. Glycated Hemoglobin (HbA1c) was below 7 % in 57.7 % of patients, and 62.3 % met their individualized HbA1c targets. Overall, 42 % of the population was obese (45.6 % of women vs 39.1 % of men; p = 0.001). Obesity rates decreased with age in both sexes. We found no association between obesity and poor glycemic control (HbA1c<7 %) (43,5 % vs 41,4 %; p = 0,17).
CONCLUSIONS
In 2022, over 60 % of people with T2DM treated by family doctors in Spain met their individualized glycemic control targets, but only one in three had good glycemic control without obesity. The use of drugs with cardiorenal benefits (particularly SGLT2 inhibitors) is higher than previous published data in our setting.
目的
分析2型糖尿病（T2DM）患者的血糖和体重控制情况，以及基层医疗中的处方模式。
方法
我们回顾了从西班牙70个健康中心随机选取的5009例T2DM患者的电子病历。我们按年龄组以及是否存在肥胖进行结果分析。所有数据均于2022年收集。
结果
在治疗方面，13.2%的样本仅接受生活方式治疗，76.5%接受二甲双胍治疗，37.6%接受钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂治疗，32.2%接受二肽基肽酶-4（DPP-4）抑制剂治疗，12.2%接受胰高血糖素样肽-1（GLP-1）受体激动剂治疗，18.9%接受胰岛素治疗，6.5%接受磺脲类药物治疗，1.3%接受格列酮类药物治疗。57.7%的患者糖化血红蛋白（HbA1c）低于7%，62.3%的患者达到了个体化HbA1c目标。总体而言，42%的人群肥胖（女性为45.6%，男性为39.1%；p = 0.001）。男女肥胖率均随年龄增长而降低。我们发现肥胖与血糖控制不佳（HbA1c<7%）之间无关联（43.5%对41.4%；p = 0.17）。
结论
2022年，在西班牙接受家庭医生治疗的T2DM患者中，超过60%达到了个体化血糖控制目标，但只有三分之一的患者在无肥胖情况下血糖控制良好。具有心肾益处的药物（尤其是SGLT2抑制剂）的使用高于我们所在地区之前发表的数据。
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