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住院梅特福林使用和住院后的临床结果:观察性队列研究
Robert J Gallo1,2, Shoutzu Lin3, Daniel Z Fang3
1Center for Innovation to Implementation, VA Palo Alto Health Care System, 795 Willow Rd (152-MPD), Menlo Park, CA, 94025, USA. rjgallo@stanford.edu.
Journal of general internal medicine
|February 3, 2025
概括
在2型糖尿病患者住院期间继续服用甲福明与出院后的胰岛素处方减少以及降低低血糖,再入院和死亡风险有关. 这挑战了目前推停止药物使用的指导方针.
科学领域:
- 内部医学 内部医学
- 内分泌学 在内分泌学.
- 临床药理学 临床药理学
背景情况:
- 甲胺是糖尿病的主要治疗方法,但其在住院患者的使用仍在争论中.
- 准则通常建议在住院期间不服用口服糖尿病药物.
- 人们担心停止使用甲福尔会造成潜在的伤害,包括增加胰岛素使用和出院后的并发症.
研究的目的:
- 评估在住院期间持续服用甲胺与住院后关键结果之间的关联.
- 评估住院患者使用甲福林对低血糖,胰岛素处方,再入院和死亡率的影响.
主要方法:
- 从2016年1月到2022年1月进行了一项模拟目标试验的观察性队列研究.
- 该研究包括了因常见疾病而入院的2型糖尿病成年患者.
- 在住院期间继续开门诊的甲福明处方是引起兴趣的主要暴露.
主要成果:
- 在67,162例住院病人的倾向匹配队列中,持续服用甲福明与90天低血糖的风险降低 (OR0.83) 和出院时的胰岛素处方 (OR0.89) 有关.
- 继续服用甲胺也与明显较低的90天再入院率 (OR 0.96) 和死亡率 (OR 0.86) 相相关.
- 对所有关键结果 (p < 0.05) 观察到统计学意义.
结论:
- 在2型糖尿病患者住院期间继续服用甲胺与出院后的改善结果有关.
- 这些发现表明,重新考虑目前的临床指导方针可能有好处,该指导方针建议暂停使用甲福明.
- 住院患者使用甲福明可能会减少胰岛素的需要,降低低血糖,再入院和死亡的风险.
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