城郊社区2型糖尿病患者治疗用药情况研究

Analysis of the Antidiabetic Therapy in Type 2 Diabetes Mellitus Patients in Suburban Community

目的分析城郊社区2糖尿病患者治疗用药情况及解决对策。方法选取社区符合1999年WHO 2型糖尿病诊断标准的患者248例,详细记录患者的一般情况、空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)及治疗用药,分析血糖水平与治疗方案的相关性,并按治疗方案不同分为1种口服降糖药组、2种口服降糖药联合组、3种以上口服降糖药联合组及胰岛素组,比较各组间FPG、2hPG及HbA1c。结果 2型糖尿病患者HbA1c水平与药物治疗方案呈正相关(r=0.2158,P=0.001),胰岛素组HbA1c显著高于口服降糖药组,胰岛素组HbA1c显著高于1种口服降糖药组和3种口服降糖药联合组,差异均有统计学意义(P<0.05)。结论 2型糖尿病患者治疗方案的选择和调整对血糖控制极为重要,应通过健康教育引导患者选择最佳的治疗方案。

Objective To analysis and countermeasure for the antidiabetic therapy in type 2 diabetes mellitus patients in suburban community. Methods The study was conducted in 248 patients with type 2 diabetes mellitas during March 2011 and September 2011. Fasting plasma glucose （FPG）, 2 -hour postprandial blood glucose （2hPG）, hemoglobin Alc （HbAi,） and the antidiabetic therapy were measured. The relationship between blood glucose levels and therapeutic regimens were analysised. According to therapeutic regimen, 248 patients were divided into four groups： one kind of oral antidiabetic drugs （ lOAD）, two kinds of oral antidiabetic drugs （2OAD）, more than three kinds of oral antidiabetic drugs （3OAD） and insulin group. Then FPG, 2hPG and HbAl~ of four groups were compared. Results There were a significantly positive correlation between HbAl~ levels and therapeutic regimens （ r =0. 2158, P =0. 005）. T test demonstrated HbAlo values of insulin group significantly higher than oral antidiabetic drugs （ P 〈0. 01 ）. Then covariance analysis showed HbAj~ of insulin group significantly higher than lOAD and 3OAD groups （P 〈0. 05 ）. Conclusion The Selection and adjustment of the therapeutic regimens play an important role in giyccmic control, the best of therapeutic regimens should be chose through health education in type 2 diabetes mellitus.