中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2011年
5期
353-357
,共5页
孙明晓%蒋蕾%汪耀%迟家敏%郭立新%于冬妮%李铭%李慧%潘琦%王晓霞%鲜彤章
孫明曉%蔣蕾%汪耀%遲傢敏%郭立新%于鼕妮%李銘%李慧%潘琦%王曉霞%鮮彤章
손명효%장뢰%왕요%지가민%곽립신%우동니%리명%리혜%반기%왕효하%선동장
糖尿病,2型%血红蛋白A,糖基化%临床方案
糖尿病,2型%血紅蛋白A,糖基化%臨床方案
당뇨병,2형%혈홍단백A,당기화%림상방안
Diabetes mellitus,type 2%Hemoglobin A,glycosylated%Clinical protocols
目的 了解我国中老年2型糖尿病患者的早期治疗策略、血糖控制及达标情况.方法 对中国糖尿病并发症防治研究中,年龄≥50岁新诊断或病程在1年内的2型糖尿病患者,在20个月内血糖控制、达标情况与早期治疗方案之间的关系进行回顾性分析;771例入选患者根据治疗方案分为未用药、单种口服药组、2种或多种口服药联合治疗组(联合治疗组)、胰岛素治疗组.结果 (1)771例患者调整治疗前均接受过不同方式的治疗,糖化血红蛋白(HbA1c )基线水平7.2%～7.7%;根据HbA1c 基线水平调整治疗方案,未用药组、单种口服药组、联合治疗组、胰岛素治疗组 HbA1c 水平分别为6.1%、7.2%、7.7%、9.2%;(2) 4种治疗方案均能快速有效地控制血糖,在20个月的随访中保持持续达标,随访末时的平均空腹血糖为(6.6±1.5)mmol/L,HbA1c (6.2±1.3)%;以HbA1c ＜7.0%为标准,除胰岛素治疗组达标率在63.2%外,其余各组达标率均在80.0%以上;(3)磺脲类和双胍类药物在单药治疗中均能达到一致的血糖控制及达标率.结论 对中老年2型糖尿病患者,根据其血糖水平制定以磺脲类和双胍类等基本口服药为主的早期多种个体化治疗措施,可以达到有效、长期、安全控制血糖的目的.
目的 瞭解我國中老年2型糖尿病患者的早期治療策略、血糖控製及達標情況.方法 對中國糖尿病併髮癥防治研究中,年齡≥50歲新診斷或病程在1年內的2型糖尿病患者,在20箇月內血糖控製、達標情況與早期治療方案之間的關繫進行迴顧性分析;771例入選患者根據治療方案分為未用藥、單種口服藥組、2種或多種口服藥聯閤治療組(聯閤治療組)、胰島素治療組.結果 (1)771例患者調整治療前均接受過不同方式的治療,糖化血紅蛋白(HbA1c )基線水平7.2%～7.7%;根據HbA1c 基線水平調整治療方案,未用藥組、單種口服藥組、聯閤治療組、胰島素治療組 HbA1c 水平分彆為6.1%、7.2%、7.7%、9.2%;(2) 4種治療方案均能快速有效地控製血糖,在20箇月的隨訪中保持持續達標,隨訪末時的平均空腹血糖為(6.6±1.5)mmol/L,HbA1c (6.2±1.3)%;以HbA1c ＜7.0%為標準,除胰島素治療組達標率在63.2%外,其餘各組達標率均在80.0%以上;(3)磺脲類和雙胍類藥物在單藥治療中均能達到一緻的血糖控製及達標率.結論 對中老年2型糖尿病患者,根據其血糖水平製定以磺脲類和雙胍類等基本口服藥為主的早期多種箇體化治療措施,可以達到有效、長期、安全控製血糖的目的.
목적 료해아국중노년2형당뇨병환자적조기치료책략、혈당공제급체표정황.방법 대중국당뇨병병발증방치연구중,년령≥50세신진단혹병정재1년내적2형당뇨병환자,재20개월내혈당공제、체표정황여조기치료방안지간적관계진행회고성분석;771례입선환자근거치료방안분위미용약、단충구복약조、2충혹다충구복약연합치료조(연합치료조)、이도소치료조.결과 (1)771례환자조정치료전균접수과불동방식적치료,당화혈홍단백(HbA1c )기선수평7.2%～7.7%;근거HbA1c 기선수평조정치료방안,미용약조、단충구복약조、연합치료조、이도소치료조 HbA1c 수평분별위6.1%、7.2%、7.7%、9.2%;(2) 4충치료방안균능쾌속유효지공제혈당,재20개월적수방중보지지속체표,수방말시적평균공복혈당위(6.6±1.5)mmol/L,HbA1c (6.2±1.3)%;이HbA1c ＜7.0%위표준,제이도소치료조체표솔재63.2%외,기여각조체표솔균재80.0%이상;(3)광뇨류화쌍고류약물재단약치료중균능체도일치적혈당공제급체표솔.결론 대중노년2형당뇨병환자,근거기혈당수평제정이광뇨류화쌍고류등기본구복약위주적조기다충개체화치료조시,가이체도유효、장기、안전공제혈당적목적.
Objective To analyze the initial treatment strategies, blood glucose control and reaching standard status of newly diagnosed type 2 diabetes mellitus (T2DM) in the middle-aged and elderly. Methods The 771 patients diagnosed with T2DM newly or within one year, aged 50-70 years, selected from Chinese Diabetes Complication Prevention Study (CDCPS) were enrolled in this study. The correlations of initial treatment strategies with blood glucose control (target value of glycated hemoglobin was less than 7.0%) and reaching standard status were analyzed retrospectively. Based on the same lifestyle intervention, the therapy was further divided into group A (without medication), group B (single oral hypoglycemic agent), group C (combined oral hypoglycemic agents), group D (treatment including insulin). Results Although receiving the different treatments, the 771 patients had a similar mean glycated hemoglobin level, from 7.2% to 7.7%, among the four kinds of intervention before entering the study. The increased intensity and complexity after therapy adjustment along with the increased glycated hemoglobin level was observed at baseline. The corresponding relationships between medication and HbA1c were as follow: without medication-6.1%, single oral hypoglycemic agent-7.2%, combined oral hypoglycemic agents-7.7%, treatment including insulin-9.2%. After 20 months of follow-up, the mean fasting glucose and glycated hemoglobin were 6.6 mmol/L and 6.2%, separately. According to the target glycated hemoglobin level of less than 7.0%, all four-kinds of therapies had high achievement rates, which were all above 80% except that was 63.2% in group D. Sulphonylurea and biguanide as initial single oral hypoglycemic agent therapy had the similar effectiveness on glucose control and target glycated hemoglobin achievement. Conclusions According to the levels of glucose and glycated hemoglobin, multiple individual therapies should be enacted at the beginning of treatment. The strategy mainly based on sulphanylurea and biguanide is proved to be persistently effective in newly-diagnosed middle-aged and elderly diabetic patients in China.
