中国大城市2型糖尿病门诊患者口服药物治疗模式调查分析

A survey on the treatment patterns of patients with type 2 diabetes mellitus in urban China

目的调查分析中国大城市2型糖尿病(type 2 diabetes mellitus,T2DM)门诊患者口服药物治疗模式的现状。方法采用横断面研究设计,在北京市、上海市、成都市和广州市整群抽取15家医院,连续募集了1 530名确诊的成人T2DM患者。研究采用自主开发的结构式问卷,由经过统一培训的调查员面对面访问研究对象,所有参与研究的对象都可以得到一次免费检测糖化血红蛋白的机会。结果在本次调查中,仅口服降糖药患者占比最多(999/1 525,65.5%),仅生活方式干预治疗的患者占比最少(23/1 525,1.5%),还有相当比例的患者联合使用口服降糖药和胰岛素(375/1 525,24.6%)。在使用口服药的患者中,使用率最高的药物为二甲双胍(783/1 374,57.0%);随着糖尿病病程延长,联合用药比例渐升高;在联合用药中,同时使用两种口服降糖药物的患者最多(634/1 374,46.1%),以磺脲类+双胍类联合使用比例最高。结论我国大城市门诊糖尿病患者的治疗以口服降糖药为主,基本符合临床指南诊疗要求。随着患者病程延长,应及时调整诊疗方案。

Objective To investigate the treatment patterns of patients with type 2 diabetes mellitus( T2DM) in urban community of Chinese big cities. Methods A cross-sectional study was carried out in 15 hospitals of Beijing,Shanghai,Chengdu and Guanghou,1 530 T2DM patients were recruited continuously into this study. Participants were face-to-face interviewed by trained interviewers using a self-developed structured questionnaire,and all participants in the study were given an opportunity to test glycosylated hemoglobin free of charge. Results Of subjects,most only used oral antidiabetic drugs( OAD)( 999/1 525,65. 5%),receiving lifestyle intervention only was the least( 23/1 525,1. 5%),and a substantial proportion used both OAD and insulin( 375/1 525,24. 6%). Among subjects with OAD,more than half of them took metformin( 783/1 374,57. 0%),and the number of OADs significantly increased as the duration of diabetes. In combination use of OADs,it was most common to have the two kinds of OAD at the same time( 634/1 374,46. 1%). Combination of metformin and sulfonylurea were the most frequently used drugs. Conclusions The OAD was popular under clinical guidelines among patients with T2DM in urban community of big Chinese cities. Treatment pattern should be adjusted with duration of T2DM.