Jaber L A, Halapy H, Fernet M, Tummalapalli S, Diwakaran H
Department of Pharmacy Practice, Wayne State University, Detroit, MI 48201, USA.
Ann Pharmacother. 1996 Mar;30(3):238-43. doi: 10.1177/106002809603000305.
To assess the effectiveness of a pharmaceutical care model on the management of non-insulin-dependent diabetes mellitus (NIDDM) in urban African-American patients.
Eligible patients were randomized to either a pharmacist intervention or control group and followed over a 4-month period. Patients in the intervention group received diabetes education, medication counseling, instructions on dietary regulation, exercise, and home blood glucose monitoring, and evaluation and adjustment of their hypoglycemic regimen. Patients in the control group continued to receive standard medical care provided by their physicians.
A university-affiliated internal medicine outpatient clinic.
The study population consisted of urban African American patients with NIDDM currently attending the clinic.
Primary outcome measures included fasting plasma glucose and glycated hemoglobin concentrations. Secondary outcome endpoints included blood pressure, serum creatinine, creatinine clearance, microalbumin to creatinine ratio, total cholesterol, triglycerides, high-density lipoprotein, and low density lipoprotein concentrations. Quality-of-life assessments were performed in both groups at baseline and at the end of the study.
Thirty-nine patients (17 intervention, 22 control) completed the study. The intervention group consisted of 12 women and 5 men with a mean +/- SD age of 59 +/- 12 years, total body weight (TBW) of 93 +/- 22 kg, body mass index (BMI) of 34 +/- 7 kg/m2, and duration of NIDDM 6.8 +/- 6.5 years. The control group consisted of 15 women and 7 men with a mean age of 65 +/- 12 years, TBW of 88 +/- 19 kg, BMI of 33 + 7 kg/m2, and a duration of NIDDM of 6.2 +/- 4.8 y. Significant improvement in glycated hemoglobin (p = 0.003) and fasting plasma glucose (p =0.015) was achieved in the intervention group. No change in glycemia was observed in the control subjects. Statistically significant differences in the final glycated hemoglobin (p = 0.003) and fasting plasma glucose (p = 0.022) concentrations were noted between groups. No significant changes in blood pressure control, lipid profile, renal function parameters, weight, or quality-of-life measures were noted within or between groups.
Our data demonstrate the effectiveness of pharmaceutical care in the reduction of hyperglycemia associated with NIDDM in a group of urban African-American patients.
评估药物治疗模式对城市非裔美国患者非胰岛素依赖型糖尿病（NIDDM）管理的有效性。
符合条件的患者被随机分为药剂师干预组或对照组，并随访4个月。干预组患者接受糖尿病教育、用药咨询、饮食调节、运动及家庭血糖监测指导，以及降糖方案的评估与调整。对照组患者继续接受医生提供的标准医疗护理。
一所大学附属医院的内科门诊。
研究人群包括目前在该门诊就诊的城市非裔美国NIDDM患者。
主要观察指标包括空腹血糖和糖化血红蛋白浓度。次要观察终点包括血压、血清肌酐、肌酐清除率、微量白蛋白与肌酐比值、总胆固醇、甘油三酯、高密度脂蛋白和低密度脂蛋白浓度。两组在基线和研究结束时均进行生活质量评估。
39名患者（17名干预组，22名对照组）完成了研究。干预组包括12名女性和5名男性，平均年龄±标准差为59±12岁，总体重（TBW）为93±22kg，体重指数（BMI）为34±7kg/m²，NIDDM病程为6.8±6.5年。对照组包括15名女性和7名男性，平均年龄为65±12岁，TBW为88±19kg，BMI为33 + 7kg/m²，NIDDM病程为6.2±4.8年。干预组糖化血红蛋白（p = 0.003）和空腹血糖（p = 0.015）有显著改善。对照组血糖无变化。两组间最终糖化血红蛋白（p = 0.003）和空腹血糖（p = 0.022）浓度存在统计学显著差异。组内或组间血压控制、血脂谱、肾功能参数、体重或生活质量指标均无显著变化。
我们的数据表明，药物治疗对一组城市非裔美国NIDDM患者降低与糖尿病相关的高血糖有效。
