门诊老年2型糖尿病患者降糖药物用药特点及使用合理性分析

Analysis of the Characteristics and Rationality of the Use of Hypoglycemic Drugs in Elderly Patients with Type 2 Diabetes in the Outpatient Department

目的分析门诊老年2型糖尿病患者使用降糖药物的特点,对药物使用合理性进行评估。方法选取2020年1—12月期间于该院门诊采用降糖药物治疗的5587例2型糖尿病老年患者作为研究对象,收集、整理患者临床资料,对患者降糖药物使用情况进行分析,总结用药特点,并分析药物使用合理性。结果降糖药物给药方式中单药口服占比最高为34.94%,注射+注射方式占比最低为9.07%;用药频率中,胰岛素类药物用药频率最高为32.57%,噻唑烷二酮类药物用药频率最低为0.65%;单药及两药联合是主要的治疗方案,最常用的单药治疗方案是胰岛素,最常用的两药联合方案是餐时胰岛素+基础胰岛素,最常用的三药联合方案是胰岛素+二甲双胍及阿卡波糖。结论该院门诊2型糖尿病老年患者降糖药物的临床使用基本合理,但二甲双胍使用率较低,未能体现出指南推荐的一线用药地位,部分联合用药会提高低血糖风险,需密切关注。

Objective To analyze the characteristics of the use of hypoglycemic drugs in elderly patients with type 2 diabetes in outpatient clinics,and evaluate the rationality of drug use.Methods A total of 5587 elderly patients with type 2 diabetes who were treated with hypoglycemic drugs in the outpatient department of the hospital from January to December 2020 were selected as the research objects.The clinical data of the patients were collected and sorted out,and the use of hypoglycemic drugs was analyzed.Summarized the characteristics of medication and analyzed the rationality of medication use.Results Among the administration methods of hypoglycemic drugs,single-drug oral administration accounted for the highest proportion of 34.94%,and injection+injection methods accounted for the lowest proportion of 9.07%.Among the medication frequency,the highest medication frequency of insulin drugs was 32.57%,and the lowest medication frequency of Thiazolidinedi one drugs was 0.65%;single-drug and two-drug combination were the main treatment options,the most commonly used single-drug treatment is insulin,the most commonly used two-drug combination was mealtime insulin+basal insulin,and the most commonly used three-drug combination was insulin+Metformin and Acarbose.Conclusion The clinical use of hypoglycemic drugs in elderly patients with type 2 diabetes in the outpatient department of this hospital is basically reasonable,but the use rate of metformin is low,which fails to reflect the status of the first-line drug recommended by the guidelines.Some combination drugs can increase the risk of hypoglycemia and require close attention.