[根据门诊专科登记资料分析1例老年2型糖尿病患者的降糖治疗结构]

Q4 Medicine
N A Pervyshin, S V Bulgakova, R A Galkin, P A Lebedev, Y A Dolgikh
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引用次数: 0

摘要

目的:对1例老年2型糖尿病(DM2)患者的降糖治疗结构进行综合临床评估,重点关注代谢综合征(肥胖、高血压、血脂异常)的伴随表现。本研究采用回顾性设计;样本由462例老年DM2合并症患者组成,其主要临床数据使用开发的数字工具和专门的正式协议存储并系统化在门诊登记处。研究临床指标、代谢状况及降糖治疗结构。并发疾病的患病率很高(高血压92%,肥胖63%,血脂异常86%),其发病机制与胰岛素抵抗密切相关,并与年龄有关。糖尿病治疗控制的关键指标:HbA1c(8.35±2.02%)、收缩压(134,93±9.48 mmHg)、LDL(2,60±1.19 mmol/L)的平均值与目标范围存在显著差异。在降糖治疗的结构中,处方胰岛素的比例很高(46.3%),包括短效胰岛素(22.6%),以及刺激葡萄糖非依赖型胰岛素分泌的药物(39.8%),这表明在选择治疗策略时并不总是考虑代谢综合征的临床表现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[The structure of hypoglycemic therapy in a comorbid elderly patient with type 2 diabetes mellitus according to the outpatient specialized registry.]

Objective - a comprehensive clinical assessment of the structure of hypoglycemic therapy in an elderly patient with type 2 diabetes mellitus (DM2) with an emphasis on concomitant manifestations of metabolic syndrome (obesity, hypertension, dyslipidemia). The study was carried out according to a retrospective design; the sample consisted of 462 comorbid elderly patients with DM2, whose primary clinical data were stored and systematized in an outpatient registry using developed digital tools and a specialized formalized protocol. Indicators of clinical and metabolic status and the structure of hypoglycemic therapy were studied. A high prevalence of concomitant diseases (hypertension - 92%, obesity - 63%, dyslipidemia - 86%) was revealed, the pathogenesis of which is closely interrelated with insulin resistance and is associated with age. A significant discrepancy between the average values of key indicators of therapeutic control of diabetes and the target ranges was noted: HbA1c (8,35±2,02%), systolic blood pressure (134,93±9,48 mmHg), LDL (2,60±1,19 mmol/L). A high proportion of prescribing insulins (46,3%), including short-acting ones (22,6%), as well as drugs that stimulate glucose-independent insulin secretion (39,8%), was determined in the structure of sugar-lowering therapy, which indicates that the clinical manifestations of metabolic syndrome are not always taken into account when choosing therapeutic tactics.

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