糖尿病患者对痛风治疗指南的依从性:一项丹麦前瞻性队列研究,随访4年。

IF 2.3
Claus Rasmussen, Jesper Walther Larsen, Peter Clement Waldhauer Holm, Søren Terpager Jepsen, Gunnar Lauge Nielsen
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摘要

目的:糖尿病影响全球约6% %的人口,其中20% %的人患有足部溃疡。痛风影响约3 %,但只有不到40% %的患者接受了适当的降尿酸治疗,以防止或溶解足部的痛风石。这项研究评估了糖尿病患者对推荐的痛风治疗的依从性。方法:从前瞻性队列的痛风患者,通过显微镜鉴定尿酸盐晶体证实,我们确定了那些伴有糖尿病。患者在不同的现实医疗环境中接受治疗。主要结局是诊断后四年达到目标血清尿酸水平:结果:286例痛风患者,85例(30 %)患有糖尿病。中位年龄为71岁,76% %为男性,有常见合并症。尿酸水平足以防止新的tophi维持在58% %。然而,45 %的患者在诊断时含有痛风石,其中只有46 %的患者达到足以溶解痛风石的水平。结论:糖尿病患者的痛风往往管理不当,可能导致持续性痛风,这可能导致溃疡并导致足部溃疡。这些发现可能反映了典型的治疗环境。负担得起和有效的痛风治疗可以防止痛风石的形成和改善预后。建议在糖尿病管理指南中考虑痛风筛查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Adherence to gout treatment guidelines in patients with diabetes: A Danish prospective cohort study with 4 years of follow-up.

Aims: Diabetes affects about 6 % of the global population, with 20 % developing foot ulcers. Gout impacts approximately 3 %, but fewer than 40 % receive adequate urate-lowering therapy to prevent or dissolve tophi in the feet. This study assessed adherence to recommended gout treatment in patients with diabetes.

Methods: From a prospective cohort of gout patients, confirmed by microscopy-identified urate crystals, we identified those with concomitant diabetes. Patients were treated in various real-life healthcare settings. The primary outcome was achieving target serum urate levels four years post-diagnosis: < 0.36 mmol/L for general gout management and < 0.30 mmol/L for tophi patients.

Results: Of 286 gout patients, 85 (30 %) had diabetes. The median age was 71 years, and 76 % were male, with common comorbidities. Urate levels sufficient to prevent new tophi were maintained by 58 %. However, 45 % had tophi at diagnosis, and only 46 % of these achieved levels low enough to dissolve tophi.

Conclusions: Gout in patients with diabetes is often inadequately managed, potentially leading to persistent tophi, which may ulcerate and contribute to foot ulcers. These findings likely reflect typical treatment settings. Affordable and effective gout treatment could prevent tophi formation and improve outcomes. Consideration of gout screening in diabetes management guidelines is recommended.

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