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首页> 外文期刊>The International journal of pharmacy practice >A review of the pharmacological management of type 2 diabetes in a rural Australian primary care cohort
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A review of the pharmacological management of type 2 diabetes in a rural Australian primary care cohort

机译：澳大利亚农村初级保健队列中2型糖尿病的药理学管理综述

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Objectives Multiple drug combination therapy aimed at controlling glucose, blood pressure, lipids and fibrinolysis significantly reduces micro- and macrovascular morbidity and mortality in patients with type 2 diabetes. The aims of this study were to (1) identify gaps between current medication management and evidence-based treatment targets in a rural cohort of Australian adults with type 2 diabetes and (2) determine patient factors associated with the prescribing of medications to patients with type 2 diabetes. Methods Two hundred and seventy-two medical records were randomly selected from a regional health service type 2 diabetes database. Demographic, biochemical, anthropometric, pharmacological, co-morbidity and lifestyle data during the initial 5 years post diagnosis were collected and analysed. Key findings Five years post type 2 diabetes diagnosis only 12% of the cohort were meeting optimal targets for glucose, blood pressure, low-density lipoprotein, high-density lipoprotein and triglyceride. Younger age (odds ratio, OR 0.96; 95% confidence interval, CI 0.94-0.99; P < 0.05) and elevated urinary microalbumin (OR 1.02; 95% CI 1.01-1.03; P < 0.05) were significantly associated with anti-diabetic medication treatment. The only independent factor associated with pharmacological treatment for hypertension was elevated HbA1c (OR 1.4; 95% CI 1.0-2.0; P < 0.05). Patient factors associated with prescription of lipid-lowering agents were a past history of cardiovascular disease (OR 5.0; 95% CI 2.0-12.5; P < 0.001), concurrent use of anti-hypertensive agents (OR 2.6; 95% CI 1.2-5.8; P < 0.05) and elevated triglyceride (OR 1.9; 95% CI 1.2-3.1; P < 0.01). Conclusion Treatment targets were not being translated into clinical practice in this cohort of patients with type 2 diabetes. Patients with acceptable HbA1c levels, with no history of cardiovascular disease and those taking few medications were at risk of being overlooked for the pharmacotherapy they required.
机译：目的旨在控制血糖，血压，脂质和纤维蛋白溶解的多种药物联合疗法可显着降低2型糖尿病患者的微血管和大血管发病率和死亡率。这项研究的目的是（1）在澳大利亚2型糖尿病成年人的农村人群中确定当前药物管理与循证治疗目标之间的差距，以及（2）确定与向2型糖尿病患者开药相关的患者因素2糖尿病。方法从区域卫生服务2型糖尿病数据库中随机抽取272份病历。诊断后最初五年内的人口统计，生化，人体测量学，药理学，合并症和生活方式数据均已收集和分析。主要发现2型糖尿病诊断五年后，只有12％的人群达到了血糖，血压，低密度脂蛋白，高密度脂蛋白和甘油三酸酯的最佳指标。较年轻的年龄（比值比，OR 0.96; 95％的置信区间，CI 0.94-0.99; P <0.05）和尿微量白蛋白升高（OR 1.02; 95％CI 1.01-1.03; P <0.05）与抗糖尿病药物显着相关治疗。与高血压药物治疗相关的唯一独立因素是HbA1c升高（OR 1.4; 95％CI 1.0-2.0; P <0.05）。与降脂药处方相关的患者因素是心血管疾病的既往史（OR 5.0; 95％CI 2.0-12.5; P <0.001），同时使用降压药（OR 2.6; 95％CI 1.2-5.8 ; P <0.05）和甘油三酸酯升高（OR 1.9; 95％CI 1.2-3.1; P <0.01）。结论该组2型糖尿病患者的治疗目标尚未转化为临床实践。 HbA1c水平可以接受的患者，没有心血管疾病的病史并且很少服用药物的患者有可能因他们需要的药物治疗而被忽视。

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