口服降糖药物联合甘精胰岛素治疗2型糖尿病的疗效分析

目的评价口服降糖药物联合甘精胰岛素治疗2型糖尿病的临床疗效。方法对我院67例单用口服降糖药物效果欠佳的2型糖尿病患者,于睡前加用甘精胰岛素治疗,比较治疗前后空腹血糖(FPG)、餐后2 h血糖(2 h PG)、空腹C肽(FCP)、餐后2 h C肽(2 h CP)、糖化血红蛋白(HbA1c)及体质量指数(BMI)等指标与低血糖发生率。结果经治疗后,患者的FPG、2 h PG和HbA1c均较治疗前明显降低,而FCP、2 h CP均较治疗前有所升高,差异均有统计学意义(P<0.05)。结论口服降糖药物联合甘精胰岛素治疗2型糖尿病疗效明显且安全性较高,患者血糖能够得到较好的控制。     

2012年～2013年口服降糖药物应用分析

目的探讨2012年~2013年口服降糖药物的临床应用现状。方法统计医院药品信息管理系统中2012年~2013年所有口服降糖药物的使用数据,对用药频度(DDDs)排序进行比较。结果二甲双胍连续两年DDDs排序第1位,阿卡波糖DDDs值及排序均有明显增长,吡格列酮连续两年DDDs排序第3位。结论我院口服降糖药物品种结构合理,以多种药物相互配合治疗为主,可减少药物对患者带来的不良反应,增加药物的治疗效果,改善患者生活质量,降低病死率。     

口服降糖药物治疗酮症倾向的糖尿病临床探析

目的探讨口服降糖药物在治疗酮症倾向糖尿病问题上的临床效果,为今后的临床实践提供医学指导。方法选取我院2011年3月～2013年6月收治酮症倾向糖尿病患者60例,按照其入院顺序进行编号、抽取,奇数为对照组,偶数为观察组,各30例。观察组口服降糖药物治疗,对部分病情无改善者采用胰岛素治疗;对照组则采用胰岛素治疗。然后收集所有患者的临床资料,对其结果进行回顾性分析。结果观察组中病情明显改善者26例(86.7%),在C肽水平、FPG以及HbA1c方面,26例患者与治疗前相比差异具有显著性意义(P<0.05);其余4例病情未改善者的C肽水平低于对照组(P<0.05)。结论口服降糖药物可明显改善酮症倾向糖尿病患者的病情,值得推广。     

广州某院2009~2011年口服降糖药物的应用分析

目的评价医院门诊口服降糖药物使用情况,为临床合理用药提供参考。方法对门诊2009年~2011年口服降糖药物的应用品种、销售金额、用药频度、日均费用等进行排序、统计、分析。结果该院口服降糖药物DDDs总值、年用药总量和年销售金额呈上升趋势,DDDs值排前三的分别是二甲双胍肠溶片、阿卡波糖片、瑞格列奈片。结论二甲双胍肠溶片、阿卡波糖片和瑞格列奈片为该院口服降糖药物的一线药物,该院口服降糖药物的用药结构基本合理。     

3种胰岛素类似物联合口服降糖药物治疗血糖控制欠佳2型糖尿病患者的疗效比较

目的：探讨血糖控制欠佳的2型糖尿病患者使用3种胰岛素类似物联合口服降糖药物的临床治疗效果。方法3组患者均给予口服二甲双胍药物治疗,A组同时给予甘精胰岛素注射液,B组同时给予预混人胰岛素30 R注射液,C 组同时给予预混门冬胰岛素注射液。记录3组患者给药前后各时间段血糖变化情况,给予统计学分析。结果经治疗后3组患者各时间段血糖值均较治疗前明显下降,A组患者下降幅度更为明显,A组与B组、C组患者治疗后血糖值对比,差异有统计学意义（P＜0.05）。结论临床医生应根据血糖控制欠佳的2型糖尿病患者实际情况,选择合适的胰岛素类似物联合口服降糖药物治疗方案,从而保障患者生活质量及生命安全。     

自拟口服中药配合自制药物牙膏对幽门螺杆菌疗效评价

幽门螺杆菌(Helicobacter pylori,Hp)首先由Barry J.Marshall和J.Robin Warren两人发现,这种细菌是一种革兰氏阴性杆菌,会导致多种疾病,如慢性胃炎、消化性溃疡、胃癌等许多胃部疾病,而幽门螺杆菌感染率在全球已经超过70%,西方发达国家的感染率稍低,在发展中国家的感染率最高,     

老年糖尿病髋关节置换术后患者出院时的药物指导

目的：探讨老年糖尿病患者髋关节置换术后出院时药物指导的意义。方法患者出院时根据血糖测定指标和肝肾功能、血压等情况选择药物,指导患者严格执行医嘱,按时用药,定时检测血糖指标,告知应用降糖药物的注意事项和不良反应,预防低血糖的方法及发生低血糖时的紧急处理措施。结果118例患者术后6～12个月获随访,降糖药物应用的依从性为96.6%,血糖测定的主要指标控制情况为理想控制为32.2%,较好控制为42.4%,一般控制为23.7%,未能控制为1.7%。结论老年糖尿病髋关节置换术后患者出院时药物指导应依据安全、有效、经济的原则,根据患者具体病情个体化给药,可提高患者的依从性,最大发挥降糖药物治疗作用,避免和降低不良反应,使患者血糖达到理想指标,促进患者的康复。     

肝切除术后应用不同疗程抗菌药物治疗对感染发生率的影响

目的 探讨肝切除术后应用不同疗程抗菌药物治疗对感染发生率的影响。方法 选取2019年11月至2023年4月南京市高淳人民医院收治的106例肝切除术患者作为研究对象,采用随机数字表法分为试验组（n=53）和对照组（n=53）。对照组采用长期抗菌药物治疗方案,试验组予以短期抗菌药物治疗方案,比较两组的治疗效果。结果 试验组术中出血量、肝门阻断时间、手术时间、腹腔双套管时间、术后下床活动时间及尿管留置时间与对照组比较,差异无统计学意义（P>0.05）;试验组术后感染发生率、并发症发生率与对照组比较,差异无统计学意义（P>0.05）。结论 肝切除术后应用长期和短期抗菌药物治疗方案对术后感染发生率的影响不大,因此需应用短期抗菌药物治疗方案以减少不良反应及耐药性。     

探讨药学指导对糖尿病患者用药依从性的影响

目的探讨糖尿病患者药师介入用药指导后患者用药依从性的改变情况。方法抽取在我院进行治疗的糖尿病患者60例,将其随机分为观察组与对照组各30例。两组均服用常规糖尿病药物及胰岛素注射进行治疗,观察组在其基础上,药师主动对其行药学指导。在治疗3个月后对其药物依从性进行评价。结果在治疗前,两组患者在药物依从性评价方面无显著差异。药师介入用药指导3个月后,观察组的药物依从性评价较对照组明显提高。结论在糖尿病的治疗方面,通过药师指导患者用药,能够将其用药依从性显著提高。     

抗菌药物耐药对住院费用影响分析

本研究采用回顾性队列研究设计,利用来自5省市10家医院2005年1～12月的住院病历数据,以临床最常见的社区肺炎、院内肺炎、尿路感染、败血症等4种疾病为代表来评价抗菌药物耐药对住院费用的影响。结果表明：抗菌药物耐药能导致病死率上升6．3％,住院时间延长15％,住院费用增长44％。应采取措施促进抗菌药物合理使用,减少耐药菌产生。     

The impact of non-severe hypoglycemic events on daytime function and diabetes management among adults with type 1 and type 2 diabetes

Abstract

Objectives:

To describe daytime non-severe hypoglycemic events (NSHEs), assess their impact on patient functioning and diabetes self-management, and examine if these impacts differ by diabetes type or country.

Methods:

Internet survey to adults with diabetes in the US, UK, Germany, and France.

Results:

Of 6756 screened respondents, 2439 reported a daytime NSHE in the past month. NSHEs occurred while active (e.g., running errands) (45.1%), 29.6% while not active (e.g., watching TV), and 23.8% at work. On average, it took half a day to respond and recover from NSHE. Respondents monitored their glucose 5.7 extra times on average over the following week. On the day of event, type 1 respondents tested significantly more often than type 2 (p?<?0.05). Type 2 were less likely to confirm NSHE with glucose test (p?<?0.001). Following NSHE, 12.6% of respondents reduced total insulin by an average of 7.6 units (SD?=?8.3). Total units and days with reduced dosing was significantly less, whilst number of additional glucose tests and time to recover was significantly longer if NSHE occurred at work (p?<?0.001). Type 1 decreased insulin doses more often (p?<?0.001); however, type 2 decreased a greater number of units (p?<?0.01). Compared with other countries, US respondents were more likely to eat a light or full meal and respondents in France took significantly longer than all other countries to recognize (p?<?0.05), respond to (p?<?0.001), and recover from (p?<?0.001) NSHE, used significantly more monitoring tests the day of (p?<?0.05) and over the subsequent week (p?<?0.001), and decreased their normal insulin dose more (p?<?0.001). Limitations of the study include potential recall bias and selection bias.

Conclusions:

NSHEs are associated with a significant impact on patient functioning and diabetes management.     

Effects of patient-reported non-severe hypoglycemia on healthcare resource use,work-time loss,and wellbeing in insulin-treated patients with diabetes in seven European countries

Abstract

Purpose:

Hypoglycemia is a frequent side effect induced by insulin treatment of type 1 (T1DM) and type 2 diabetes (T2DM). Limited data exist on the associated healthcare resource use and patient impact of hypoglycemia, particularly at a country-specific level. This study investigated the effects of self-reported non-severe hypoglycemic events (NSHE) on use of healthcare resources and patient wellbeing.

Methods:

Patients with T1DM or insulin-treated T2DM diabetes from seven European countries were invited to complete four weekly questionnaires. Data were collected on patient demographics, NSHE occurrence in the last 7 days, hypoglycemia-related resource use, and patient impact. NSHE were defined as events with hypoglycemia symptoms, with or without blood glucose measurement, or low blood glucose measurement without symptoms, which the patient could manage without third-party assistance.

Results:

Three thousand, nine hundred and fifty-nine respondents completed at least one wave of the survey, with 57% completing all four questionnaires; 3827 respondents were used for data analyses. Overall, 2.3% and 8.9% of NSHE in patients with T1DM and T2DM, respectively, resulted in healthcare professional contact. Across countries, there was a mean increase in blood glucose test use of 3.0 tests in the week following a NSHE. Among respondents who were employed (48%), loss of work-time after the last hypoglycemic event was reported for 9.7% of NSHE. Overall, 10.2% (daytime) and 8.0% (nocturnal) NSHE led to work-time loss, with a mean loss of 84.3 (daytime) and 169.6 (nocturnal) minutes among patients reporting work-time loss. Additionally, patients reported feeling tired, irritable, and having negative feelings following hypoglycemia.

Limitations:

Direct comparisons between studies must be interpreted with caution because of different definitions of hypoglycemia severity, duration of the studies, and methods of data collection.

Conclusions:

NSHE were associated with use of extra healthcare resources and work-time loss in all countries studied, suggesting that NSHE have considerable impact on patients/society.     

The economic impact of insulin-related hypoglycemia in Denmark: an analysis using the Local Impact of Hypoglycemia Tool

Aims: To estimate the direct cost of hypoglycemia in insulin-treated adults with type 1 diabetes (T1DM) and type 2 diabetes (T2DM) in Denmark.

Materials and methods: The Local Impact of Hypoglycemia Tool (LIHT) was used to estimate the costs associated with insulin-related hypoglycemia. Average utilization of healthcare resources, including the costs of pre-hospitalization, hospital admission, healthcare professional contact and follow-up, glucose/glucagon, and extra SMBG tests to monitor blood glucose following an episode, was used to calculate an average cost per severe and per non-severe hypoglycemic episode. The cost per episode was then applied to the rates of severe and non-severe hypoglycemia in people with T1DM and T2DM in Denmark.

Results: The direct cost of insulin-related hypoglycemia in Denmark is DKK 96.2 million per year, which equates to EUR 12.9 million. For people with T1DM prone to severe hypoglycemia (defined as having ≥2 severe episodes in the past year), the cost per person per year increases by DKK 4,155 compared with the T1DM population average, and for people with T2DM prone to non-severe hypoglycemia (defined as having ≥1 non-severe episode in the last 4 weeks), the cost increases by DKK 647 per person per year compared with the T2DM population average.

Conclusions: The LIHT highlights the substantial economic burden of insulin-related hypoglycemia in Denmark, and provides a means to estimate the savings that could be made by lowering hypoglycemia rates. For example, the costs associated with using a new insulin or introducing a patient education program could be offset with the cost saving from reducing hypoglycemia.