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頁籤選單縮合
題名 | 基礎胰島素治療第2型糖尿病人之糖化血色素和體重的變化=The Effects of Basal Insulin Treatment on Type 2 Diabetic Patients as Assessed by HbA1c and Body Weight |
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作者 | 施李碧玉; 張美智; 張伶祝; 洪建德; | 書刊名 | 北市醫學雜誌 |
卷期 | 9:3 2012.09[民101.09] |
頁次 | 頁205-213 |
分類號 | 415.6681 |
關鍵詞 | 糖尿病; 基礎胰島素; 糖化血色素; 體重; Diabetes mellitus; DM; Basal insulin; Glycosylated hemoglobin; HbA1c; Body weight; |
語文 | 中文(Chinese) |
中文摘要 | 糖尿病是一種代謝異常的慢性疾病,大多需要長期嚴格的監控血糖,以胰島素治療可迅速矯正高血糖,然多數病人往往擔心使用基礎胰島素會造成體重增加,而不願意接受基礎胰島素治療。本研究之目的乃針對糖尿病人以基礎胰島素治療一年後,探討其糖化血色素的改善程度和體重的變化。方法:本研究以立意取樣方式選取某市立教學醫院新陳代謝科門診病人,篩選條件為規律看診、注射基礎胰島素且接受藥事照護之第2型糖尿病病人為研究對象,記錄其性別、年齡、教育程度、注射基礎胰島素一年前後之糖化血色素和體重等,以paired t-test作統計分析,來探究其前後之變化,糖化血色素高低之改善程度的相關性以Mantel-Haenszel Chi-Square作分析。結果:本研究共計收案323人,包括男性155人,女性168人,平均年齡為63.7歲,平均糖化血色素值為8.8%,平均體重為65.2公斤。注射基礎胰島素一年,總體糖化血色素值平均降低0.56%,體重平均增加1.43公斤,故糖化血色素與體重兩者均具統計學上顯著的差異(p<0.0001)。結論:由本研究驗證得知,第2型糖尿病人使用基礎胰島素治療一年後,其糖化血色素可獲得有意義的改善,然體重卻會顯著的增加。因此需加強教導病人規律運動和清淡飲食之減重衛教,以減少相關不良影響發生率。更建議推動糖尿病關懷協會等社區資源,讓糖尿病人及其家屬定期參加健康講座,能獲得正確的規律運動和飲食控制衛教知識,並改變其行為,以預防或延緩併發症的發生,讓糖尿病人擁有較好的生活品質。 |
英文摘要 | Type 2 diabetes mellitus (DM) is a chronic disease characterized by abnormal carbohydrate metabolism and in general requires long-term intensive glycemic control. Parenteral insulin treatment can promptly bring about well-controlled blood glucose. However, most patients are concerned about an elevation in their body weight and therefore decline the basal insulin treatment. The purpose of this study is aimed at exploring the well-being of patients by examining improvements in glycosylated hemoglobin (HbA1c) and changes in body weight after one year of basal insulin treatment. Methods: The study was carried out at a Metabolic Clinic at Taipei City Hospital from January to May, 2008. Study subjects were type 2 DM patients who routinely visiting the clinic and received complete follow-up studies over a one-year period. Clinic data and demographic data were collected including sex, age and education level. After one year of basal insulin treatment, any changes in HbA1c and body weight were recorded and statistically analyzed using the paired t-test. Results: In total, 323 patients participated in this study, of which 155 were male and 168 were female. The average of age of the patients was 63.7 years. The average HbA1c was 8.8%, and the average of body weight was 65.2 kg. After one year of basal insulin treatment, the HbA1c value had dropped on average by 0.56% and body weight had increased on average by 1.48 kg; both values were statistically significant (p<0.0001). Conclusion: Among type 2 diabetic patients who have been treated with basal insulin for a whole year, it was found that HbA1c was significantly improved, while body weight had increased. In light of these finding, it seem that it would be beneficial to patients if their anxiety with respect to body weight elevation was mitigated. |
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