본문 바로가기
KERD
논문KCI 등재

Frequency and Severity of Hypoglycemia in Type 2 Diabetes Mellitus Patients Treated with a Sulfonylurea-Based Regimen at University-Affiliated Hospitals in Korea: The Naturalistic Evaluation of Hypoglycemic Events in Diabetic Subjects Study

2

조회

0

다운로드

3

인용

0

참고문헌

키워드

주제분류가정의학

초록

Background: We assessed the frequency and severity of hypoglycemia in type 2 diabetes mellitus patients treated with sulfonylurea monotherapy or sulfonylurea+metformin.Methods: We conducted a retrospective, observational, cross-sectional study in 2011 and 2012 including patients with type 2 diabetes mellitus aged ≥30 years who were treated with ≥6 months of sulfonylurea monotherapy or sulfonylurea+metformin at 20 university-affiliated hospitals in Korea. At enrollment, glycated hemoglobin (HbA1c) was assessed; participants completed self-reported questionnaires describing hypoglycemia incidents over the past 6 months. A review of medical records up to 12 months before enrollment provided data on demographics, disease history, comorbidities, laboratory results, and drug usage. Results: Of 726 enrolled patients, 719 were included (55.6% male); 31.7% and 68.3% were on sulfonylurea monotherapy and sulfonylurea+metformin, respectively. Mean±standard deviation age was 65.9±10.0 years; mean HbA1c level was 7.0%±1.0%; 77.8% of patients had hypertension (89.4% used antihypertensive medication); 60.5% had lipid disorders (72.5% used lipid-lower-ing medication); and 52.0% had one or more micro- or macrovascular diseases. Among patients with A1c measurement (n=717), 56.4% achieved therapeutic goals (HbA1c <7.0%); 42.4% (305/719) experienced hypoglycemia within 6 months of enrollment; and 38.8%, 12.9%, 12.7%, and 3.9% of patients experienced mild, moderate, severe, and very severe hypoglycemia symptoms, respec-tively. Several reported hypoglycemia frequency as 1–2 times over the last 6 months. The mean number of very severe hypoglyce-mia episodes was 3.5±5.5.Conclusion: Among type 2 diabetes mellitus patients treated with sulfonylurea-based regimens, glycemic levels were relatively well controlled but hypoglycemia remained a prevalent side effect.

Abstract

Background: We assessed the frequency and severity of hypoglycemia in type 2 diabetes mellitus patients treated with sulfonylurea monotherapy or sulfonylurea+metformin.Methods: We conducted a retrospective, observational, cross-sectional study in 2011 and 2012 including patients with type 2 diabetes mellitus aged ≥30 years who were treated with ≥6 months of sulfonylurea monotherapy or sulfonylurea+metformin at 20 university-affiliated hospitals in Korea. At enrollment, glycated hemoglobin (HbA1c) was assessed; participants completed self-reported questionnaires describing hypoglycemia incidents over the past 6 months. A review of medical records up to 12 months before enrollment provided data on demographics, disease history, comorbidities, laboratory results, and drug usage. Results: Of 726 enrolled patients, 719 were included (55.6% male); 31.7% and 68.3% were on sulfonylurea monotherapy and sulfonylurea+metformin, respectively. Mean±standard deviation age was 65.9±10.0 years; mean HbA1c level was 7.0%±1.0%; 77.8% of patients had hypertension (89.4% used antihypertensive medication); 60.5% had lipid disorders (72.5% used lipid-lower-ing medication); and 52.0% had one or more micro- or macrovascular diseases. Among patients with A1c measurement (n=717), 56.4% achieved therapeutic goals (HbA1c <7.0%); 42.4% (305/719) experienced hypoglycemia within 6 months of enrollment; and 38.8%, 12.9%, 12.7%, and 3.9% of patients experienced mild, moderate, severe, and very severe hypoglycemia symptoms, respec-tively. Several reported hypoglycemia frequency as 1–2 times over the last 6 months. The mean number of very severe hypoglyce-mia episodes was 3.5±5.5.Conclusion: Among type 2 diabetes mellitus patients treated with sulfonylurea-based regimens, glycemic levels were relatively well controlled but hypoglycemia remained a prevalent side effect.

참고문헌 (21)

  1. International Diabetes Federation, "IDF diabetes atlas" (2011), International Diabetes Federation
  2. Zenari L, "What are the preferred strategies for control of glycaemic variability in patients with type 2 diabetes mellitus?", Diabetes Obes Metab, 15(Suppl 2), pp.17~25 (2013)
  3. Charpentier G, "Management of drugs affecting blood glucose in diabetic patients with renal failure", Diabetes Metab, 26(Suppl 4), pp.73~85 (2000)
  4. Evans JM, "Risk of mortality and adverse cardiovascular outcomes in type 2 diabetes : a comparison of patients treated with sulfonylureas and metformin", Diabetologia, 49, pp.930~936 (2006)
  5. Simpson SH, "Doseresponse relation between sulfonylurea drugs and mortality in type 2diabetes mellitus : a population-based cohort study", CMAJ, 174, pp.169~174 (2006)
  6. Banarer S, "Hypoglycemia in type 2 diabetes", Med Clin North Am, 88, pp.1107~1116 (2004)
  7. Del Prato S, "The place of sulfonylureas in the therapy for type 2 diabetes mellitus", Metabolism, 55(5 Suppl 1), pp.S20~S27 (2006)
  8. Miller CD, "Hypoglycemia in patients with type 2 diabetes mellitus", Arch Intern Med, 161, pp.1653~1659 (2001)
  9. Ben-Ami H, "Drug-induced hypoglycemic coma in 102 diabetic patients", Arch Intern Med, 159, pp.281~284 (1999)
  10. Browne DL, "What do patients with diabetes know about their tablets", Diabet Med, 17, pp.528~531 (2000)
  11. UBcare Co. Ltd, "UBIquitous STatistics (UBIST) data 2009", UBcare Co. Ltd, ~ (2009)
  12. American Diabetes Association, "Standards of medical care in diabetes--2011", Diabetes Care, 34(Suppl 1), pp.S11~S61 (2011)
  13. Alvarez Guisasola F, "Hypoglycaemic symptoms, treatment satisfaction, adherence and their associations with glycaemic goal in patients with type 2 diabetes mellitus: findings from the Real-Life Effectiveness and Care Patterns of Diabetes Management (RECAP-DM) Study", Diabetes Obes Metab, 10(Suppl 1), pp.25~32 (2008)
  14. UK Hypoglycaemia Study Group, "Risk of hypoglycaemia in types 1 and 2 diabetes : effects of treatment modalities and their duration", Diabetologia, 50, pp.1140~1147 (2007)
  15. Chan SP, "Hypoglycemic symptoms in patients with type 2 diabetes in Asia-Pacific-Real-life effectiveness and care patterns of diabetes management : the RECAP-DM study", Diabetes Res Clin Pract, 89, pp.e30~2 (2010)
  16. Wild D, "A critical review of the literature on fear of hypoglycemia in diabetes : Implications for diabetes management and patient education", Patient Educ Couns, 68, pp.10~15 (2007)
  17. Alvarez Guisasola F, "Glycaemic control among patients with type 2 diabetes mellitus in seven European countries : findings from the Real-Life Effectiveness and Care Patterns of Diabetes Management(RECAP-DM)Study", Diabetes Obes Metab, 10(Suppl 1), pp.8~15 (2008)
  18. Amiel SA, "Hypoglycaemia in type 2 diabetes", Diabet Med, 25, pp.245~254 (2008)
  19. Nattrass M, "Review of prandial glucose regulation with repaglinide:a solution to the problem of hypoglycaemia in the treatment of type 2 diabetes?", Int J Obes Relat Metab Disord, 24(Suppl 3), pp.S21~S31 (2000)
  20. Coteur G, "Evaluation of the meaningfulness of health-related quality of life improvements as assessed by the SF-36 and the EQ-5D VAS in patients with active Crohn’s disease", Aliment Pharmacol Ther, 29, pp.1032~1041 (2009)
  21. Shikiar R, "The validity and responsiveness of three quality of life measures in the assessment of psoriasis patients : results of a phase II study", Health Qual Life Outcomes, 4, pp.71~ (2006)

관련 논문AI추천

Severe hypoglycemia as a preventable risk factor for cardiovascular disease in patients with type 2 diabetes mellitusSeung-Hyun Ko, Soo-Yeon Choi대한내과학회 · The Korean Journal of Internal Medicine2021 · 제36권 제2호제2형 당뇨병 환자에서 Metformin/Dipeptidyl Peptidase-4 저해제 병용요법과 Metformin/Sulfonylurea 병용요법간의 효과에 대한 비교 연구곽혜선, 김재연, 김주희, 박선이, 박지혜한국임상약학회 · 한국임상약학회지2015 · 제25권 제2호Blood electrolyte disturbances during severe hypoglycemia in Korean patients with type 2 diabetes강미연대한내과학회 · The Korean Journal of Internal Medicine2015 · 제30권 제5호제 2형 당뇨 환자에서 Sitagliptin과 Sulfonylurea계 약물 병용 시혈당 조절 효과와 저혈당 발현에 관한 연구강민경, 김향숙, 오정미, 정선회, 최경희한국병원약사회 · 병원약사회지2014 · 제31권 제3호Characteristics Predictive for a Successful Switch from Insulin Analogue Therapy to Oral Hypoglycemic Agents in Patients with Type 2 Diabetes강은석, 김규리, 이병완, 이용호, 이현철, 차봉수연세대학교의과대학 · Yonsei Medical Journal2016 · 제57권 제6호Combination therapy of oral hypoglycemic agents in patients with type 2 diabetes mellitus고승현, 김난희, 김진화, 김현진, 문민경, 박석오, 이병완, 이상열, 최경묵, 허규연, the Committee of Clinical Practice Guideline of KDA대한내과학회 · The Korean Journal of Internal Medicine2017 · 제32권 제6호

이 간행물의 다른 논문 (15건)