抗糖尿病药物使用与血糖控制之间的关系:新加坡的一项基于糖尿病登记的回顾性队列研究
Sze Ling Chan1,2, Charyl Jia Qi Yap3, Yingqi Xu4
1Health Services Research Centre, Singapore Health Services Pte Ltd, Singapore gmscsli@nus.edu.sg.
BMJ open
|September 19, 2025
概括
糖尿病 (DM) 药物使用和血糖控制有着复杂的关系. 持续使用DM药物,特别是口服药物,与改善HbA1c水平有关,这表明血糖控制更好.
科学领域:
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 糖尿病 (DM) 管理需要有效的药物坚持,以实现最佳的血糖控制.
- 了解DM药物使用与患者结果之间的关联对于临床实践至关重要.
研究的目的:
- 调查糖尿病 (DM) 药物使用与血糖控制之间的关系.
- 分析DM药物所覆盖日数 (PDC) 的比例与糖化血红蛋白 (HbA1c) 水平变化之间的相关性.
主要方法:
- 这是一项回顾性队列研究,使用了SingHealth糖尿病注册表 (2013-2020) 的数据.
- 包括18岁以上的患有发生性DM的患者.
- 通过PDC测量DM药物使用并评估HbA1c变化;使用后勤回归和克鲁斯卡尔-瓦利斯测试进行分析.
主要成果:
- 分析包括了36314名患者.
- 任何DM药物,口服DM药物和胰岛素的PDC中位数分别为20.3%,16.8%和0%.
- 良好的基线血糖控制与较低的DM药物使用有关,而较差的控制或缺失的HbA1c数据与更高的持续使用相关 (PDC>80%).
结论:
- 糖尿病药物使用和血糖控制之间的关联是复杂的和非单调的.
- 总体DM药物和口服DM药物的较高PDC与临床上有意义的HbA1c改善有显著的联系.
相关概念视频
Diabetes Mellitus: Type 2 and Gestational
4.9K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
4.9K
Diabetes: Management and Pharmacotherapy
1.5K
The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
1.5K
Oral Hypoglycemic Agents: Biguanides and Glitazones
993
Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
993
Oral Hypoglycemic Agents: α-Glucosidase Inhibitors
953
α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
Acarbose and miglitol are...
Acarbose and miglitol are...
953
Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis
17
Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated...
17
Hypoglycemia
30
Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...
30


