北京部分社区2型糖尿病患者降糖用药情况分析

 目的 通过调查北京市部分社区2型糖尿病患者降糖用药情况,了解不同版本《国家基本药物目录》中降糖药物(简称国家基本降糖药物)的覆盖情况。方法 纳入北京市4个社区卫生服务中心的2型糖尿病患者900例,以糖化血红蛋白(HbA1c)<7%为目标控制血糖,随访1年后比较不同版本国家基本降糖药物使用覆盖率的变化。结果 (1)基线时:应用2012年版国家基本降糖药物的比例(91.4%)明显高于应用2009年版目录药物的比例(42.9%)(χ²=481.09,P<0.05)。7种国家基本降糖药物中,阿卡波糖(48.9%)、二甲双胍(40.7%)和重组人胰岛素(31.1%)的覆盖率较高(χ²=1519.65,P<0.05)。(2)1年后随访:总人群HbA1c达标率(53.6%)较基线时(32.3%)提高(χ²=77.26,P<0.05)。应用2012年版国家基本降糖药物的比例(85.5%)仍明显高于应用2009年版目录药物的比例(37.4%)(χ²=376.367,P<0.05)。阿卡波糖(49.7%)、二甲双胍(36.3%)和重组人胰岛素(30.4%)的覆盖率仍较高(χ²=1320.70,P<0.05)。结论 2012年版的国家基本降糖药物较2009年版可更好地满足北京社区2型糖尿病患者的需求。
   

An analysis of hypoglycemic agents used among patients with type 2 diabetes in Beijing communities

Objective To compare the coverage rate of the hypoglycemic agents base on 2009 and 2012 versions of the national essential medicine list among patients with type 2 diabetes mellitus (T2DM) in Beijing communities. Methods A total of 900 patients with T2DM were enrolled in the study from four community health service centers in Beijing and followed up for one year. The following data were collected and analyzed, including patients characteristics, the proportion of patients with glycosylated hemoglobin A1c (HbA1c) less than 7% and the coverage rate of the hypoglycemic agents. Results (1) The coverage rate of using the hypoglycemic agents in 2012 version of the national essential medicine list was significantly higher than that in 2009 version(91.4% vs 42.9%, χ²=481.09,P<0.05). The coverage rates of the seven hypoglycemic agents in national essential medicine list were significantly different(χ²=1519.65,P<0.05). The coverage rates of acarbose(48.9%), metformin(40.7%) and human insulin(31.1%) were higher than those of glimepiride(9.4%), glipizide (3.0%), glibenclamide (0.6%) and animal insulin(0.2%). (2) After one year follow-up, the proportion of the patients with HbA1c less than 7% was higher than that at the baseline(53.6% vs 32.3%, χ²=77.26,P<0.05). The coverage rate of using the hypoglycemic agents in 2012 version of the national essential medicine list was significantly higher than that in 2009 version(85.5% vs 37.4%, χ²=376.367,P<0.05). The coverage rates of acarbose(49.7%), metformin(36.3%) and insulin(30.4%) were still higher than those of glimepiride(6.3%), glipizide(2.2%),glibenclamide(0.4%) and animal insulin(0.0%). Conclusion The hypoglycemic agents in 2012 version of the national essential medicine list could meet the current need of the type 2 diabetes patients in Beijing communities better than those in 2009 version.