糖化血红蛋白控制达标的2型糖尿病患者用药状况分析

目的了解控制达标的2型糖尿病患者用药情况,为临床合理用药提供参考。方法对334例糖化血红蛋白(HbA_(lc))≤6.5%的2型糖尿病患者行空腹血糖、C肽测定,同时调查糖尿病药物用药情况,对药物的分布及频率进行分析。结果 334例HbA_(lc)达标的患者中,使用频率最高的药物是糖苷酶抑制剂(49.7%)。全部患者中有56.6%(189/334)进行了联合用药。最常见的联合用药方案是:预混胰岛素+糖苷酶抑制剂(10.5%)及磺脲类+糖苷酶抑制剂(9.9%)。根据使用胰岛素与否,行多元回归分析发现:使用胰岛素与糖尿病病程正相关,与空腹C肽水平成负相关(均P<0.01)。结论 HbA_(lc)控制达标的患者多数需要联合用药。糖尿病病程越长,C肽水平越低,越需要使用胰岛素。

Utilization of hypoglycemic agents in type 2 diabetic patients with wellcontrolled glycosylated hemoglobin

AIM To investigate the utilization of hypoglycemic agents in type 2 diabetic patients with well-controlled glycosylated hemoglobin A_(1c)(HbA(1c)).METHODS A total of 334 type 2 diabetic patients with HbA_(1c)≤6.5%were enrolled in the study.The case history,physical examination and biochemical tests were conducted.Fasting plasma glucose and C-peptide were tested.The usage of hypoglycemic agents was summarized and analyzed in respect of category,amount,frequency and combined use.RESULTS Of all the drugs prescribed,the glycosidase inhibitors ranked the first(49.7%).The combination of hypoglycemic agents was 56.6%(189 patients)of total patients.Of all the combination of hypoglycemic agents,mixtard insulin combined with glycosidase inhibitors(10.5%)and sulfonylureas combined with glycosidase inhibitors(9.9%)ranked the first two places in terms of the medication frequency.Multiple logistic regression analysis confirmed that the duration of diabetes correlated positively,while fasting C-peptide correlated inversely with the usage of insuli (both P<0.01).CONCLUSION In type 2 diabetic patients with well-controlled HbA_(1c),the combination hypoglycemic agents is common.Longer duration of diabetes and lower level of fasting C-peptide will be the ris factors of insulin using.