新诊断的2型糖尿病患者第一年口服降糖药依从性和长期并发症

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice Pub Date : 2025-08-05 DOI:10.1016/j.diabres.2025.112405

Nam Hoon Kim , Jun Sung Moon , Kyoung Hwa Ha , Jihyun Kim , Kyoung-Eun Kwon , Sin Gon Kim , Dae Jung Kim

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引用次数: 0

摘要

目的：2型糖尿病（T2D）是一个日益严重的公共卫生问题，早期治疗依从性可能影响长期预后。本研究评估了诊断后一年内口服降糖药（OADs）依从性与并发症和死亡风险之间的关系。方法：采用具有全国代表性的健康声明数据库进行回顾性队列研究。2009年新诊断为T2D的患者在12个 月内开始OAD单药治疗。随访从依从性指标日期开始持续至死亡、随访缺失或研究结束。患者在第一年的依从性水平分为良好（≥80 %）和不良(结果：65,340例患者中，46.9%（30,657例）表现出良好的依从性。与较差的依从性相比，良好的依从性与大血管事件风险降低23%，糖尿病相关住院风险降低8%，全因死亡率降低28%相关。结论：早期坚持使用OADs与T2D患者并发症和死亡率降低相关。促进新诊断患者的依从性对于改善长期预后至关重要。

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First-year oral antidiabetic adherence and long-term complications in newly diagnosed type 2 diabetes

Aims

Type 2 diabetes (T2D) is a growing public health issue, with early treatment adherence potentially impacting long-term outcomes. This study assessed the association between adherence to oral antidiabetic drugs (OADs) during the first year after diagnosis and the risk of complications and mortality.

Methods

A retrospective cohort study was conducted using a nationally representative health claims database. Patients newly diagnosed with T2D in 2009 who initiated OAD monotherapy within 12 months were included. Follow-up continued from the adherence index date until death, loss of follow-up, or study end. Patients were categorized by adherence level during the first year: good (≥ 80 %) and poor (< 80 %). Outcomes included macrovascular events, diabetes-related hospitalizations, and all-cause mortality. Hazard ratios were estimated using Cox proportional hazards models with inverse probability of treatment weighting.

Results

Among 65,340 patients, 46.9 % (n = 30,657) showed good adherence. Compared to poor adherence, good adherence was associated with a 23 % lower risk of macrovascular events, an 8% lower risk of diabetes-related hospitalizations, and a 28 % lower risk of all-cause mortality.

Conclusions

Early adherence to OADs was associated with a reduced risk of complications and mortality in T2D patients. Promoting adherence in newly diagnosed individuals is crucial for improving long-term outcomes.

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来源期刊

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.