美国退伍军人患有糖尿病前期的甲福明处方,2010-2019年
Barbara I Gulanski1,2, Joseph L Goulet3,4, Krishnan Radhakrishnan5
1Department of Medicine, Endocrinology, VA Connecticut Healthcare System, West Haven, CT, USA.
概括
在退伍军人事务部为糖尿病前期处方甲胺的处方率低至1.1%,在高风险人群中略有增加至1.6%. 这项研究强调,尽管某些患者群体的风险增加,但在预防糖尿病方面使用甲胺的比例很低.
科学领域:
- 内分泌学 在内分泌学.
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 糖尿病前期影响了8.8亿美国人,显著增加了2型糖尿病 (T2DM) 和心血管疾病的风险.
- 甲胺是预防糖尿病的关键药物,但其在退伍军人卫生管理局 (VHA) 的利用仍然未得到充分研究.
- VHA是美国最大的综合医疗保健系统,为患T2DM风险较大的人口提供服务.
研究的目的:
- 确定被诊断患有糖尿病前期疾病的退伍军人中,被处方甲胺的比例.
- 在这个人群中确定与甲福林处方相关的因素.
- 评估VHA系统内用于糖尿病预防的甲福明的使用情况.
主要方法:
- 追溯观察队列研究的设计.
- 来自VHA的电子健康记录的分析 (2010年10月 - 2019年9月).
- 包括1,059,605名患有糖尿病前期病例的退伍军人,检查甲福尔处方率和相关的临床因素.
主要成果:
- 只有1.1%的患有糖尿病前期的退伍军人接受了甲福林处方.
- 在2型糖尿病进展风险增加的子组 (例如,BMI ≥35 kg/m2,年龄 <60岁,HbA1c ≥6.0%) 中,甲福明的处方量略高 (1.6%).
- 甲福明处方的可能性更高与更高的BMI,女性性别,升高的HbA1c,年轻年龄,高三糖血,高血压,严重抑郁症和精神分裂症有关.
结论:
- 在VHA中,对糖尿病前期的甲福明的处方特别低,即使在高危人群中也是如此.
- 这表明,在这个庞大的医疗保健系统中,在使用甲胺用于糖尿病预防策略方面存在潜在的差距.
- 需要进行进一步的研究,以了解障碍,并优化在退伍军人中糖尿病前期管理的甲福林使用.
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