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泰国老年 2 型糖尿病患者最佳糖尿病护理及并发症的时间趋势:一项全国性研究。

Temporal trends in optimal diabetic care and complications of elderly type 2 diabetes patients in Thailand: A nationwide study.

机构信息

Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand.

Department of Internal Medicine, Bassett Medical Center, New York City, New York, USA.

出版信息

J Evid Based Med. 2019 Feb;12(1):22-28. doi: 10.1111/jebm.12318. Epub 2018 Nov 5.

Abstract

BACKGROUND

This study aimed to assess the nationwide trends in optimal diabetic care and complications of elderly type 2 diabetes mellitus (T2DM) patients over a 6-year period in Thailand.

METHODS

T2DM patients aged 65 years or older who received medical care at public hospitals in Thailand from 2010 to 2015 were included. The optimal T2DM care in elderly patients was defined as (1) blood pressure (BP) < 140/90, (2) hemoglobin A1C (HbA1c) < 7%, (3) low-density lipoprotein cholesterol (LDL-C) < 100 mg/dL, (4) use of antiplatelet medications, and (5) use of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) in hypertensive patients. T2DM treatment-related complications included hospital admissions due to dysglycemia.

RESULTS

A total of 54 295 elderly T2DM patients were enrolled in this study. From 2010 to 2015, there was an increasing trend in the achievement of BP control and use of antiplatelet medications (P for trend < 0.01), whereas there was a decreasing trend in the achievement of HbA1c and LDL-C control among elderly T2DM patients (P for trend < 0.001). There was an increasing trend in the use of ACEI/ARB among elderly T2DM patients with hypertension (P for trend < 0.001). Hospital admissions due to dysglycemia decreased over the study period (P for trend < 0.001).

CONCLUSION

There has been a trend change for diabetic care among elderly T2DM patients in Thailand. Further studies are needed to assess the impact on patient outcomes.

摘要

背景

本研究旨在评估泰国 6 年内老年 2 型糖尿病(T2DM)患者的最佳糖尿病治疗和并发症的全国趋势。

方法

本研究纳入了 2010 年至 2015 年在泰国公立医院接受治疗的年龄在 65 岁及以上的 T2DM 患者。老年患者的最佳 T2DM 治疗定义为:(1)血压(BP)<140/90mmHg;(2)糖化血红蛋白(HbA1c)<7%;(3)低密度脂蛋白胆固醇(LDL-C)<100mg/dL;(4)使用抗血小板药物;(5)高血压患者使用血管紧张素转换酶抑制剂(ACEI)或血管紧张素 II 受体阻滞剂(ARB)。T2DM 治疗相关并发症包括因血糖异常导致的住院治疗。

结果

本研究共纳入了 54295 名老年 T2DM 患者。2010 年至 2015 年,BP 控制和抗血小板药物的使用率呈上升趋势(趋势 P<0.01),而 HbA1c 和 LDL-C 控制率呈下降趋势(趋势 P<0.001)。高血压老年 T2DM 患者中 ACEI/ARB 的使用率呈上升趋势(趋势 P<0.001)。因血糖异常导致的住院治疗呈下降趋势(趋势 P<0.001)。

结论

泰国老年 T2DM 患者的糖尿病治疗趋势发生了变化。需要进一步研究来评估其对患者结局的影响。

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