拉萨地区2型糖尿病住院患者降糖治疗分析

摘要

Objective To investigate the use of hypoglycemie agents in hospitalized patients with type 2 diabetes in Lhasa before admission.Method Patients diagnosed with type 2 diabetes who were hospitalized in our department from January 2016 to December 2016 were recruited.General information,blood pressure,HbA1c,fasting plasma glucose,low-density lipoprotein cholesterol and chronic complications were collected.Patients' medication before admission recorded in detail.Result Before admission,48.3％ of patients did not use any hypoglycemic drugs.Among all the antidiabelic drugs,metformin was used in 94 cases (34.4％),Tibetan medicine in 72 cases (26.4％),and combination therapy in 84 cases (30.8％);Patients who were treated with insulin reported a median diabetes duration of 36 months when they initiated insulin treatment.Among the patients who were already on insulin treatment,they have a fasting glucose level (10.5 ± 3.5)mmol/L and HbA1c level (10.3 ± 2.3)％ far above the target.A total of 47 chronic complications accounted for 69.1％ of patients with insulin use.Conclusion Before admission,many patients in Lhasa did not use any hypoglycemic drugs.The proportion of patients with type 2 diabetes who were taking metformin and who is using combination therapy are very low.Tibetan medicine is still very popular in this area.Insulin treatment is always delayed in our patients.There is an urgent need to further standardize the treatment of patients with type 2 diabetes in Lhasa.%目的 调查拉萨地区2型糖尿病住院患者入院前降糖药使用情况.方法 选取西藏自治区人民医院内分泌科2016年1月至2016年12月明确诊断为2型糖尿病的住院患者,收集入院时一般资料、血压、糖化血红蛋白、空腹血糖、低密度脂蛋白胆固醇及慢性并发症等资料,详细询问并记录患者入院前用药情况.结果 入院前48.3％的患者未使用降糖药物.使用降糖药物的患者中,使用二甲双胍94例(34.4％),藏药72例(26.4％),联合用药者84例(30.8％).应用胰岛素降糖的患者,起始降糖治疗中位时间为36个月,入院时空腹血糖为(10.5±3.5) mmol/L,糖化血红蛋白为(10.3±2.3)％,均不达标,慢性并发症发生率为69.1％(47例).结论 拉萨地区2型糖尿病住院患者入院前大部分未使用降糖药物,二甲双胍占所用降糖药物的比例低,使用藏药者多,胰岛素起始治疗时间晚,联合用药比例低,未来亟需进一步规范拉萨地区2型糖尿病患者的治疗.