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目的:分析老年糖尿病患者住院期间血糖控制水平的合理性,评估住院患者潜在的过度治疗风险情况,从而为合理用药提供依据。方法:对2015年1月至2015年11月入院的235位老年糖尿病患者(≥65岁)进行描述性统计分析。结果:在235例住院老年糖尿病患者中,71.5%的患者健康状况较好,18.3%的患者病史较复杂存在并发症(2组),10.2%的患者至少有一种严重的合并症,生命预期较短(3组)。在235例患者中,17%的患者入院时Hb A1c<7%;在Hb A1c<7%的患者中,37.5%的患者接受了胰岛素或磺脲类药物治疗。出院时,空腹血糖≤7和餐后血糖≤11的患者分别占1、2、3组患者的比例为:2/3、约1/2和不足1/3。结论:按照患者合并疾病的严重程度的由轻到重,出院时患者的血糖达标比例逐渐降低。虽然如此,高风险的降糖药物仍可能导致治疗风险和经济负担的增加。对预期寿命较短、病史复杂的患者更适合通过改变生活方式和使用低风险降糖药物,如二甲双胍等来降糖。
OBJECTIVE: To analyze the rationality of glycemic control during the hospitalization of elderly diabetic patients and to evaluate the potential risk of over-treatment in hospitalized patients so as to provide a basis for rational drug use. Methods: Descriptive statistics were performed on 235 elderly diabetic patients (≥65 years) admitted to hospital from January 2015 to November 2015. RESULTS: Of the 235 hospitalized elderly patients with diabetes, 71.5% had better health status, 18.3% had more complicated history (2 groups), 10.2% had at least one serious comorbid condition, Short (3 groups). Of the 235 patients, 17% had Hb A1c <7% at admission; 37.5% of patients with Hb A1c <7% received insulin or sulfonylurea. At discharge, patients with fasting blood glucose ≤7 and postprandial blood glucose ≤11 accounted for 2/3, about 1/2, and less than 1/3 of patients, respectively. Conclusion: According to the severity of patients with combined disease from light to heavy, discharge of patients at the gradual reduction in the proportion of blood glucose. Nonetheless, high-risk hypoglycemic drugs may still lead to increased treatment risk and financial burden. Patients with shorter life expectancy and more complicated history are more likely to have hypoglycemic effects by changing their lifestyle and using low-risk hypoglycemic drugs such as metformin.