初诊2型糖尿病的老年患者口服降糖药物治疗方案的效价对比及低血糖的研究

Cost- effectiveness of oral hypoglycemic drug treatment program in elderly patients of newly diagnosed type 2 diabetes and hypoglycemia rate

目的:调查我院初诊2型糖尿病的老年患者常用的三组口服降糖药物治疗方案,进行3个治疗方案的成本-效果分析,并了解低血糖发生比例,为老年患者选择降糖治疗方案提供参考。方法:采用回顾性调查,将我院初诊2型糖尿病的老年患者,均在口服二甲双胍的基础上,A组加用格列美脲,B组加用瑞格列奈,C组加用吡格列酮,采集监测的血糖值和糖化血红蛋白作为效果测量指标,进行成本-效果分析,并统计低血糖发生次数。结果:三组间患者的基本情况比较,差异无统计学意义(P>0.05)。ABC组治疗方案的药物成本均数为675.15元,875.95元,650.15元,3组治疗方案效价比A组大于B、C组,B组和C组之间无统计学差异,A组发生低血糖比例明显大于B、C组。结论:对于2型糖尿病患者的初始治疗,选用格列美脲联合二甲双胍的治疗方案效价比高,但低血糖发生率高。高龄、智能和认知障碍、自理能力差、肝肾功能减退、预计远期寿命较短的患者可选择使用瑞格列奈的治疗方案。

Objective To investigate commonly used three oral hypoglycemic drug treatment programs in elderly patients ofnewly diagnosed type 2 diabetes in our hospital,analyse their cost - effectiveness,and learn hypoglycemia rate,to provide a referenceof antidiabetic treatment options for elderly patients. Method Retrospective survey was performed, elderly patients of newly diagnosedtype 2 diabetes in our hospital were treated with Glimepiride ( Group A) , Repaglinide ( Group B) and Pioglitazone ( Group C ),respectively, besides oral metformin. Blood glucose levels and glycated hemoglobin were measurement indicators, cost - effectivenessof three treatment programs were analysed,the number of statistical hypoglycemia was calculated. Results The basic situation wasno significant difference among the three groups of patients(P >0. 05). Average drug costs of Group A,B and C were ￥675. 15,875. 95 and 650. 15 Respectively,program A had a higher cost - effectiveness than program B and C,there was no significant differencebetween program B and C. Hypoglycemia rate in group A was significantly greater than group B, C. Conclusion For the initialtreatment of type 2 diabetes, Glimepiride in combination with metformin has a higher cost - effectiveness and hypoglycemiarate. Patients with age, cognitive disorders, poor self - care, liver and kidney dysfunction, expected long - term short - life may useRepaglinide treatment.