Diabetes Care:抗糖尿病药物使用的长期趋势分析!

2017-11-07 xing.T MedSci原创

由此可见,大多数患者在糖化血红蛋白水平升高的情况下开始服用二线ADD治疗。尽管引入新的治疗方法,磺脲类药物仍然是最受欢迎的二线ADD,采用磺脲类药物和胰岛素进行强化治疗的几率随着时间的推移保持一致。相比于磺脲类药物,基于肠促胰岛素治疗与延迟强化治疗相关。

近日,糖尿病领域权威杂志Diabetes Care上发表了研究文章,研究人员旨在探讨降糖药物(ADD)处方和强化方案、血糖水平和并发症以及新的ADD延迟2型糖尿病患者使用胰岛素可能效益的时间趋势。

研究人员从美国电子医疗记录中心中选择了18-80岁的2型糖尿病患者(n=1023340)。研究人员确定了那些在服用一线二甲双胍治疗后添加二线ADD的患者组成亚组(n=357482);并对第三线治疗药物的选择进行了进一步的探讨。

从2005年到2016年,一线用药二甲双胍有所增加(60-77%),而磺脲类药物有所减少(20-8%)。在服用二甲双胍的亚组中,平均随访3.4年后,48%的患者在平均糖化血红蛋白为8.4%时添加了第二个降糖药。在亚组中,虽然磺酰脲类药物被当成二线治疗药物使用有所下降(60-46%),它仍然是最受欢迎的二线ADD选择。胰岛素(7-17%)和二肽基肽酶抑制剂(DPP-4I)(0.4-21%)的使用有所增加。采用胰岛素和磺脲类药物强化治疗率并未在过去10年中下降。在二线药物DPP-4I(7.1年)和胰高血糖素样肽1受体激动剂(6.6年)治疗过程中开始使用胰岛素的平均时间稍长,相比于磺脲类药物(6.3年,P<0.05)。

由此可见,大多数患者在糖化血红蛋白水平升高的情况下开始服用二线ADD治疗。尽管引入新的治疗方法,磺脲类药物仍然是最受欢迎的二线ADD,采用磺脲类药物和胰岛素进行强化治疗的几率随着时间的推移保持一致。相比于磺脲类药物,基于肠促胰岛素治疗与延迟强化治疗相关。

原始出处:

Olga Montvida,et al. Long-term Trends in Antidiabetes Drug Usage in the U.S.: Real-world Evidence in Patients Newly Diagnosed With Type 2 Diabetes.Diabetes Care 2017 .Diabetes Care 2017. https://doi.org/10.2337/dc17-1414

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encodeId=d187161629943, content=<a href='/topic/show?id=3b125560052' target=_blank style='color:#2F92EE;'>#抗糖尿病药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55600, encryptionId=3b125560052, topicName=抗糖尿病药物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b41d19737356, createdName=ms6980045490879608, createdTime=Thu Nov 09 03:52:00 CST 2017, time=2017-11-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=259453, encodeId=393b2594535f, content=不错的.学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdqKgfW3nMpOkC3jXxiaW2po0PtglY5ZuVjERqKADW4HyMI8bcZXWlKgH7tEP9ULBoBzuQMibia4pr1s9rQPqLvqQJ/0, createdBy=e8c02060444, createdName=中医痴, createdTime=Tue Nov 07 13:06:26 CST 2017, time=2017-11-07, status=1, ipAttribution=)]
    2017-11-09 虈亣靌

    谢谢分享谢谢分享

    0

  7. 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  8. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Thu Nov 09 13:17:06 CST 2017, time=2017-11-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1584105, encodeId=038f1584105d8, content=<a href='/topic/show?id=1f13e6767e9' target=_blank style='color:#2F92EE;'>#糖尿病药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76767, encryptionId=1f13e6767e9, topicName=糖尿病药物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5edb17003695, createdName=minhuang75_72521589, createdTime=Thu Nov 09 03:52:00 CST 2017, time=2017-11-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1616299, 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  9. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Thu Nov 09 13:17:06 CST 2017, time=2017-11-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1584105, encodeId=038f1584105d8, content=<a href='/topic/show?id=1f13e6767e9' target=_blank style='color:#2F92EE;'>#糖尿病药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76767, encryptionId=1f13e6767e9, topicName=糖尿病药物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5edb17003695, createdName=minhuang75_72521589, createdTime=Thu Nov 09 03:52:00 CST 2017, time=2017-11-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1616299, encodeId=d187161629943, content=<a href='/topic/show?id=3b125560052' target=_blank style='color:#2F92EE;'>#抗糖尿病药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55600, encryptionId=3b125560052, topicName=抗糖尿病药物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b41d19737356, createdName=ms6980045490879608, createdTime=Thu Nov 09 03:52:00 CST 2017, time=2017-11-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=259453, encodeId=393b2594535f, content=不错的.学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdqKgfW3nMpOkC3jXxiaW2po0PtglY5ZuVjERqKADW4HyMI8bcZXWlKgH7tEP9ULBoBzuQMibia4pr1s9rQPqLvqQJ/0, createdBy=e8c02060444, createdName=中医痴, createdTime=Tue Nov 07 13:06:26 CST 2017, time=2017-11-07, status=1, ipAttribution=)]
    2017-11-07 中医痴

    不错的.学习了.谢谢分享!

    0