TYPE 2 DIABETES MELLITUS’S DECOMPENSATED FORM: ON THE PROBLEM OF EFFECTIVE PHARMACOTHERAPY IN REAL CLINICAL PRACTICE

A. Safronenko, E. Gantsgorn, E. A. Sanina, M. A. Khachumova, S. Panenko, I. Kuznetsov, A. A. Kivva, V. Polyakova
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Abstract

The aim of this retrospective study was to analyze the pharmacotherapy regimens of the decompensated form of type 2 diabetes mellitus (DM2) and to evaluate its effectiveness, its compliance with clinical recommendations.Materials and methods: A retrospective analysis of 54 medical cards of patients with decompensated DM2 was conducted. The 1st group (n=24; 44%) included the patients who had a decrease in glycated hemoglobin (HbA1c) by 50% or more in 3 months after hypoglycemic therapy; and the 2nd group (n=30; 56%) – the patients whose HbA1c level decreased by less than 50%.Results. A HbA1c level was 10.4% in the 1st group and 13.2% in the 2nd group (р<0.001). However, the target levels of venous blood plasma glucose and HbA1c were not achieved in any of the patient groups. The total number of the drugs prescribed to the patients ranged from 4 (in 25% (n=6) and 10% (n=3) cases in the 1st and the 2nd groups, respectively) to 8 (in 12.5% (n=3) and 20% (n=6) cases in the 1st and the 2nd, groups, respectively). However, in a number of cases some violations of clinical recommendations were recorded: the prescription to the obese patients of insulin drugs, the administration of sulfonylureas derivatives to patients with a history of cardiovascular diseases of the atherosclerotic origin, but modern hypoglycemic drugs with proven benefits in reducing cardiovascular risks were rarely prescribed.Conclusion. The tactics of pharmacotherapy in the patients with a decompensated form of DM2 does not fully comply with the approved clinical guidelines, which requires the effectiveness of treatment optimization of this medically and socially significant pathology.
2型糖尿病失代偿型:临床实践中有效药物治疗的问题
本回顾性研究的目的是分析失代偿型2型糖尿病(DM2)的药物治疗方案,并评估其有效性及其对临床建议的依从性。材料与方法:对54例DM2失代偿患者的医疗卡进行回顾性分析。第一组(n=24;44%)包括在降糖治疗后3个月内糖化血红蛋白(HbA1c)下降50%或以上的患者;第二组(n=30;56%) - HbA1c水平下降小于50%的患者。第一组HbA1c水平为10.4%,第二组为13.2% (p <0.001)。然而,在任何一组患者中,静脉血血糖和HbA1c均未达到目标水平。给患者开的总药物数从1组25% (n=6)、2组10% (n=3)的4种到1组12.5% (n=3)、2组20% (n=6)的8种不等。然而,在一些情况下,记录了一些违反临床建议的情况:给肥胖患者开胰岛素药物,给有动脉粥样硬化起源的心血管疾病史的患者开磺脲类衍生物,但很少开现代降糖药,证明对降低心血管风险有益。失代偿型DM2患者的药物治疗策略不完全符合批准的临床指南,这需要对这种医学和社会意义重大的病理进行治疗优化的有效性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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