Primary Care Diabetes最新文献_第6页

Managing type 1 diabetes at work – A qualitative meta-synthesis 在工作中管理1型糖尿病-定性综合。

IF 2.3 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-10-01 Epub Date: 2025-07-08 DOI: 10.1016/j.pcd.2025.06.009

Emma Victoria Shiel , Steve Hemingway , Rajeeb Kumar Sah , Kim Burton

Aims

To interpret the available qualitative research findings on people’s experiences of managing type 1 diabetes at work.

Methods

A qualitative meta-synthesis was conducted using constant comparative methods, reciprocal analysis, and a line of argument synthesis, which were expressed narratively.

Results

The study included thirteen articles, revealing a complex relationship between type 1 diabetes and work. People with type one diabetes want minimal interference in their daily routines while balancing health and work responsibilities. The concept of 'containment' emerged as a key strategy, where self-management is integrated alongside work demands. However, this approach may inadvertently lead to psychosocial conflicts and detrimental health outcomes.

Conclusions

The findings highlight the importance of creating supportive and empowering workplaces to reduce the tensions between type one diabetes and work. Enabling people with type one diabetes to self-manage effectively while maintaining autonomy requires support that both fosters self-management and avoids isolation. This sort of supportive and empowering work environment for workers with type one diabetes could contribute to facilitating [re]entry and retention in the workforce. This synthesis adds to contemporary knowledge, particularly in qualitative areas, yet further study is needed to identify specific actions that can create more accommodating workplaces for people with type one diabetes.

目的：对工作中管理1型糖尿病经验的定性研究结果进行解释。方法：采用恒比较法、互反分析和论述线综合等方法进行定性综合。结果：该研究包括13篇文章，揭示了1型糖尿病与工作之间的复杂关系。1型糖尿病患者希望在平衡健康和工作责任的同时，尽量减少对日常生活的干扰。“遏制”的概念成为一项关键战略，将自我管理与工作要求结合起来。然而，这种做法可能在不经意间导致社会心理冲突和有害的健康后果。结论：研究结果强调了创造支持性和赋权工作场所的重要性，以减少1型糖尿病患者与工作之间的紧张关系。使1型糖尿病患者在保持自主性的同时有效地进行自我管理，需要既促进自我管理又避免孤立的支持。这种为1型糖尿病患者提供支持和授权的工作环境有助于促进[重新]进入和留在劳动力市场。这种综合增加了当代知识，特别是在定性领域，但需要进一步研究确定具体行动，为1型糖尿病患者创造更便利的工作场所。

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引用次数: 0

Pattern of semaglutide prescription in a real-world Canadian patient cohort 西马鲁肽在加拿大真实患者队列中的处方模式。

IF 2.3 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-10-01 Epub Date: 2025-06-24 DOI: 10.1016/j.pcd.2025.06.006

Armin Farahvash , Michelle CM Lee , Rahul Jain , Liisa Jaakkimainen

Aims

Despite the growing interest in the broad applications of semaglutide, real-world data on its use in weight-loss is limited. This study aims to explore the pattern of semaglutide prescriptions in a Canadian family medicine practice.

Methods

This retrospective study included patients ≥ 18 years who were enrolled in Sunnybrook Academic Family practice in Toronto, Canada and prescribed semaglutide between January 2018 and April 2024. Baseline demographics, weight measurements up to 16 months, and prescription details were collected. Descriptive statistics was used to illustrate the patterns of semaglutide prescription.

Results

Of 9930 enrolled patients, 368 (3.71 %) were prescribed semaglutide and 335 used it. Mean age was 57.7 ± 14.1 years and 63.3 % were female. Mean BMI was 36.6 ± 7.84 kg/m². Semaglutide was discontinued due to side effects in 11 (3.3 %) within one month and 27 (8.1 %) at any time. There was an increasing trend in semaglutide prescriptions from 2018 to 2023. There were increasing semaglutide prescriptions for weight-loss, and prescriptions by family physicians compared to specialists. Follow up measurements showed a mean weight-loss of 7.5 % in 212 patients.

Conclusions

In an Ontario academic family practice, semaglutide is being more frequently prescribed in the primary care setting, particularly for weight loss.

目的：尽管人们对西马鲁肽的广泛应用越来越感兴趣，但其在减肥中的实际应用数据有限。本研究旨在探讨西马鲁肽处方模式在加拿大家庭医学实践。方法：本回顾性研究纳入≥ 18岁的患者，这些患者于2018年1月至2024年4月在加拿大多伦多Sunnybrook学术家庭诊所登记，并服用了西马鲁肽。收集了基线人口统计数据、16个月前的体重测量数据和处方细节。描述性统计用于说明西马鲁肽处方的模式。结果：在9930例入组患者中，368例（3.71 %）处方了西马鲁肽，335例使用了西马鲁肽。平均年龄57.7 ± 14.1岁，女性63.3% %。平均BMI为36.6 ± 7.84 kg/m2。11例（3.3 %）患者在1个月内因副作用停药，27例（8.1 %）患者在任何时间停药。2018 - 2023年，西马鲁肽处方呈增加趋势。与专科医生相比，家庭医生开具的用于减肥的西马鲁肽处方越来越多。随访测量显示212例患者的平均体重减轻了7.5% %。结论：在安大略省的学术家庭实践中，西马鲁肽在初级保健环境中被更频繁地开处方，特别是减肥。

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引用次数: 0

Trends in metabolic risk factors control among adults with type 2 diabetes: A comparative study of 2018 and 2021 成人2型糖尿病患者代谢危险因素控制趋势：2018年和2021年的比较研究

IF 2.3 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-10-01 Epub Date: 2025-07-03 DOI: 10.1016/j.pcd.2025.06.008

Fereshteh Baygi, Peter Haastrup, Helene Støttrup Andersen, Sonja Wehberg, Jens Søndergaard

Aims

This study aims to analyze recent trends in managing major metabolic risk factors among type 2 diabetes patients (T2D) over time.

Methods

We used data from the Danish Adult Diabetes Registry (DVDD) on health indicators in 2018 and 2021. Information about medication was found using Danish National Prescription Registry (DNPR). Cut points for abnormal values of the included health indicators were identified from the revised National Cholesterol Education Program Adult Treatment Panel III criteria. Correspondingly, reached target levels were defined. A logistic regression model based on generalized estimating equations was fitted to evaluate the difference between 2018 and 2021.

Results

We included 24,343 and 18,027 observations in 2018 and 2021, respectively. Longitudinal analyses showed statistically significant improvement in Low density lipoprotein, Blood pressure, triglycerides, and Glycated hemoglobin control overtime. The use of glucose-lowering and lipid-lowering medications, and antihypertensive medication increased. Obesity declined significantly overtime. Subgroup analyses highlighted improvement in metabolic control across age groups, with TG control declining in T2D patients over 60 years.

Conclusions

We found statistically significant improvement in metabolic risk factor control and medication use over time. Despite progress in managing LDL, BP, and HbA1c, challenges remain in Blood pressure and triglycerides control.

目的：本研究旨在分析2型糖尿病患者（T2D）主要代谢危险因素管理的最新趋势。方法：我们使用了丹麦成人糖尿病登记处（DVDD） 2018年和2021年健康指标的数据。使用丹麦国家处方登记处（DNPR）查找有关药物的信息。从修订后的国家胆固醇教育计划成人治疗小组III标准中确定了所包括健康指标异常值的切点。相应地，确定了达到的目标水平。拟合基于广义估计方程的logistic回归模型，评估2018年与2021年的差异。结果：我们在2018年和2021年分别纳入了24,343和18,027项观察结果。纵向分析显示，随着时间的推移，低密度脂蛋白、血压、甘油三酯和糖化血红蛋白的控制有统计学意义的改善。降糖、降脂药物和抗高血压药物的使用增加。随着时间的推移，肥胖率显著下降。亚组分析强调了各年龄组代谢控制的改善，60岁以上T2D患者的TG控制下降。结论：我们发现随着时间的推移，代谢危险因素控制和药物使用有统计学意义的改善。尽管在控制LDL、BP和HbA1c方面取得了进展，但在血压和甘油三酯控制方面仍然存在挑战。

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引用次数: 0

Cognitive impairment is associated with poor diabetic foot ulcer outcomes 认知障碍与糖尿病足溃疡预后不良相关。

IF 2.3 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-10-01 Epub Date: 2025-07-29 DOI: 10.1016/j.pcd.2025.07.008

Christopher Girgis , Stephanie Behme , Crystal Holmes , Sari Priesand , Evan L. Reynolds , Jihyun Park , Pearl G. Lee , Brian M. Schmidt

Background

Up to one-third of individuals with diabetes develop diabetic foot ulcers (DFU), and cognitive impairment affects up to 34 % of this population. This study evaluates the impact of cognitive impairment on ulcer outcomes.

Methods

This six-year retrospective study analyzed ICD-9/10 codes from a large tertiary health system. Eligible patients had DFU and at least six months of follow-up. Exclusions were made for those without an ulcer and not seen by a podiatrist. For the cohort without cognitive impairment, patients were excluded if they screened positive for cognitive impairment or dementia in the five years prior to diagnosis. Clinical outcomes were assessed using the Wound, Ischemic, Foot Infection classification, focusing on healing rates, time to healing, amputation events, and hospital admissions. Logistic regression determined associations between cognitive impairment and DFU outcomes.

Results

Of 631 charts reviewed, 123 patients were included: 56 with cognitive impairment (mean age 71.9) and 67 without (mean age 58). Healing rates at six months were lower for those with cognitive impairment (39 % vs. 72 %, p < 0.001). They had higher rates of major amputations (17.8 % vs. 5.9 %, odds ratio 4.5, p < 0.05) and foot-related admissions (p = 0.01).

Conclusions

Individuals with DFU and cognitive impairment were at higher risk of major amputation, foot-related admissions, and nonhealing, underscoring the need for targeted interventions.

背景：高达三分之一的糖尿病患者患有糖尿病足溃疡（DFU），认知障碍影响高达34% %的这一人群。本研究评估认知障碍对溃疡预后的影响。方法：这项为期六年的回顾性研究分析了来自大型三级卫生系统的ICD-9/10代码。符合条件的患者有DFU和至少6个月的随访。排除那些没有溃疡和没有看过足病医生的人。对于没有认知障碍的队列，如果患者在诊断前5年内认知障碍或痴呆筛查呈阳性，则排除在外。临床结果采用伤口、缺血、足部感染分类进行评估，重点关注愈合率、愈合时间、截肢事件和住院率。逻辑回归确定了认知障碍和DFU结果之间的关联。结果：在回顾的631张图表中，纳入123例患者：56例有认知障碍（平均年龄71.9岁），67例无认知障碍（平均年龄58岁）。认知障碍患者6个月的治愈率较低（39% %对72% %，p ）。结论：DFU和认知障碍患者发生主要截肢、足部相关入院和不愈合的风险较高，强调了有针对性干预的必要性。

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引用次数: 0

Response to comment on “Comment on characteristics of metabolic inflammatory syndrome among inpatients with type 2 diabetes: A cross-sectional study in China” 对“关于中国住院2型糖尿病患者代谢性炎症综合征特征的横断面研究”评论的回复

IF 2.3 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-10-01 Epub Date: 2025-07-30 DOI: 10.1016/j.pcd.2025.07.006

Mengjuan Xue, Bin Lu

This manuscript addresses several comments raised by Dr. Liao on metabolic inflammatory syndrome (MIS) in type 2 diabetes inpatients. It explains the limitations including selection bias in the study population, lack of exploration of molecular mechanisms, and discrepancies in dyslipidemia findings.

本文针对廖博士提出的关于2型糖尿病住院患者代谢炎症综合征（MIS）的几点意见。它解释了局限性，包括研究人群的选择偏倚，缺乏对分子机制的探索，以及血脂异常发现的差异。

引用次数: 0

Achieving meaningful reduction of HgbA1c in pediatric type 1 diabetes requires an individualized approach 在儿童1型糖尿病中实现有意义的糖化血红蛋白降低需要个体化的方法。

IF 2.3 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-10-01 Epub Date: 2025-07-21 DOI: 10.1016/j.pcd.2025.07.005

Andrew Kanouse , Joanna S. Fishbein , Parissa Salemi

Objective

Individuals with diabetes often have difficulty attaining a goal hemoglobin A1c < 7.0 %. Diabetes care is multifactorial, including medications, education, and lifestyle intervention. Individuals with a hemoglobin A1c (HgbA1c) > 10 % are especially at risk for complications. The aim of this study was to evaluate the association of technological interventions [continuous glucose monitors (CGM) and/or continuous subcutaneous insulin infusion devices (CSII, i.e. insulin pumps)] and frequency of clinic visits with improvement of HgbA1c values in children with type 1 diabetes (T1D) who have a HgbA1c > 10 %.

Research design and methods

A chart review was performed for patients with T1D who had a HgbA1c > 10 % and a diagnosis of T1D for greater than 1 year between 2018 and 2019 analyzing demographic data, treatment modality, and frequency of visits to determine if a clinically meaningful HgbA1c reduction (>0.5 %) was achieved.

Results

One hundred and forty-seven children were evaluated. Altogether, 9 children (53 %) with CGM only, 18 (64 %) with CSII only, and 14 (78 %) with combination use achieved a clinically significant reduction as compared to 50 (60 %) with no technology. When evaluating number of visits, 41 children (61 %) with 1–2 visits, 40 (60 %) with 3, 19 (70 %) with 4, and 5 (50 %) with 5–6 achieved reduction.

Conclusions

These results show that while either use of technology or increased clinic visits may improve the ability to achieve meaningful HgbA1c reductions, this may not be true for all patients. While some patients may need numerous clinic visits, others may be able to make dramatic changes with only two visits. Similarly, while some may benefit from CGM use alone, others may improve their HgbA1c with a CSII or no technology. Given the intricacies of diabetes care, this data supports that patients would likely benefit from a tailored treatment plan catered to their individual needs to best optimize their HgbA1c.

目的：糖尿病患者通常难以达到目标血红蛋白A1c 10 %，特别有并发症的风险。本研究的目的是评估技术干预[连续血糖监测仪（CGM）和/或连续皮下胰岛素输注装置（CSII，即胰岛素泵）]和临床就诊频率与改善HgbA1c值的关系，1型糖尿病儿童（T1D）的HgbA1c为bb0 10 %。研究设计和方法：对2018年至2019年期间诊断为T1D的HgbA1c > 10 %超过1年的T1D患者进行图表回顾，分析人口统计学数据、治疗方式和就诊频率，以确定是否实现了临床有意义的HgbA1c降低（>0.5 %）。结果：对147名儿童进行了评估。总的来说，9名儿童（53 %）单独使用CGM， 18名儿童（64 %）单独使用CSII， 14名儿童（78 %）联合使用相比，50名儿童（60 %）没有技术实现了临床显著的降低。在评估就诊次数时，41名儿童（61 %）进行1-2次就诊，40名儿童（60 %）进行3次就诊，19名儿童（70 %）进行4次就诊，5名儿童（50 %）进行5-6次就诊。结论：这些结果表明，虽然使用技术或增加门诊就诊可以提高实现有意义的hba1c降低的能力，但这可能并不适用于所有患者。虽然有些病人可能需要多次就诊，但有些人可能只需要两次就诊就能产生巨大的变化。同样，虽然有些人可能从单独使用CGM中受益，但其他人可能通过CSII或不使用CSII技术来改善他们的hba1c。鉴于糖尿病护理的复杂性，该数据支持患者可能受益于针对其个人需求的量身定制的治疗计划，以最佳地优化其hba1c。

{"title":"Achieving meaningful reduction of HgbA1c in pediatric type 1 diabetes requires an individualized approach","authors":"Andrew Kanouse , Joanna S. Fishbein , Parissa Salemi","doi":"10.1016/j.pcd.2025.07.005","DOIUrl":"10.1016/j.pcd.2025.07.005","url":null,"abstract":"<div><h3>Objective</h3><div>Individuals with diabetes often have difficulty attaining a goal hemoglobin A1c < 7.0 %. Diabetes care is multifactorial, including medications, education, and lifestyle intervention. Individuals with a hemoglobin A1c (HgbA1c) <u>></u> 10 % are especially at risk for complications. The aim of this study was to evaluate the association of technological interventions [continuous glucose monitors (CGM) and/or continuous subcutaneous insulin infusion devices (CSII, i.e. insulin pumps)] and frequency of clinic visits with improvement of HgbA1c values in children with type 1 diabetes (T1D) who have a HgbA1c <u>></u> 10 %.</div></div><div><h3>Research design and methods</h3><div>A chart review was performed for patients with T1D who had a HgbA1c > 10 % and a diagnosis of T1D for greater than 1 year between 2018 and 2019 analyzing demographic data, treatment modality, and frequency of visits to determine if a clinically meaningful HgbA1c reduction (>0.5 %) was achieved.</div></div><div><h3>Results</h3><div>One hundred and forty-seven children were evaluated. Altogether, 9 children (53 %) with CGM only, 18 (64 %) with CSII only, and 14 (78 %) with combination use achieved a clinically significant reduction as compared to 50 (60 %) with no technology. When evaluating number of visits, 41 children (61 %) with 1–2 visits, 40 (60 %) with 3, 19 (70 %) with 4, and 5 (50 %) with 5–6 achieved reduction.</div></div><div><h3>Conclusions</h3><div>These results show that while either use of technology or increased clinic visits may improve the ability to achieve meaningful HgbA1c reductions, this may not be true for all patients. While some patients may need numerous clinic visits, others may be able to make dramatic changes with only two visits. Similarly, while some may benefit from CGM use alone, others may improve their HgbA1c with a CSII or no technology. Given the intricacies of diabetes care, this data supports that patients would likely benefit from a tailored treatment plan catered to their individual needs to best optimize their HgbA1c.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 5","pages":"Pages 522-526"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comment on ‘Characteristics of metabolic inflammatory syndrome among inpatients with type 2 diabetes: A cross-sectional study in China’ 《中国住院2型糖尿病患者代谢性炎症综合征的特点：一项横断面研究》

IF 2.3 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-10-01 Epub Date: 2025-05-03 DOI: 10.1016/j.pcd.2025.04.003

Mao Liao

This commentary critically evaluates the cross - sectional study by Li et al. on metabolic inflammatory syndrome (MIS) in type 2 diabetes (T2D) inpatients. It points out limitations including selection bias in the study population, lack of exploration of molecular mechanisms, and discrepancies in dyslipidemia findings. Additionally, it proposes prospective cohort studies and specific research directions to enhance the understanding of MIS as a risk factor for coronary heart disease and improve its clinical relevance.

这篇评论批判性地评价了Li等人关于2型糖尿病（T2D）住院患者代谢炎症综合征（MIS）的横断面研究。它指出了局限性，包括研究人群的选择偏倚，缺乏对分子机制的探索，以及血脂异常发现的差异。并提出前瞻性队列研究和具体研究方向，以增强对MIS作为冠心病危险因素的认识，提高其临床相关性。

引用次数: 0

Impact of a primary care-based mobile health intervention to ‘sit less and move more’ on HbA1c, blood pressure, and other clinical outcomes in office employees with type 2 diabetes: A randomized controlled trial 基于初级保健的移动健康干预“少坐多动”对2型糖尿病办公室员工HbA1c、血压和其他临床结果的影响：一项随机对照试验

IF 2.3 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-10-01 Epub Date: 2025-06-09 DOI: 10.1016/j.pcd.2025.05.010

Francesc Alòs , Ma Àngels Colomer , Judit Bort-Roig , Carlos Martin-Cantera , Alicia Minaya , Ignasi Saigí , Miquel Sitjar-Suñer , Anna Puig-Ribera

Background

Type 2 diabetes (T2D) is a prevalent and costly disease, with sedentary behaviour and physical inactivity as modifiable contributors. Mobile health (mHealth) applications provide complementary strategies for T2D management, but their impact on clinical outcomes remains unclear.

Objective

This study evaluated the efficacy of an mHealth programme promoting “sit less and move more” at work, prescribed in clinical practice, on clinical and cardiovascular risk factors in office employees with T2D.

Methods

A randomized controlled trial compared usual care (n = 25) with a 13-week mHealth intervention (n = 29) using the Walk@Work-App and web-based tools. Outcomes included HbA1c, glycemia, lipid profile, domain-specific sedentary behaviour (Workforce Sitting Questionnaire), objective physical activity and sedentary behaviour (ActivPal), blood pressure, and BMI at baseline, 6, and 12 months.

Results

Compared to the control group and at 12 months, the intervention group showed a significant reduction in HbA1c (p < 0.05), systolic and diastolic blood pressure (p < 0.05). Sitting time decreased during leisure activities while watching TV (p = 0.0052) and using electronic devices (p = 0.0397). The number of sedentary breaks and time spent in sedentary bouts <20 min/day increased (p < 0.05).

Conclusions

An mHealth programme effectively reduced sedentary behaviour, improved HbA1c and blood pressure, serving as a cost-effective lifestyle intervention for adults with T2D.

Trial registration

ClinicalTrials.gov NCT04092738.https://clinicaltrials.gov/ct2/show/NCT04092738

背景：2型糖尿病（T2D）是一种普遍且昂贵的疾病，久坐行为和缺乏身体活动是可改变的因素。移动医疗（mHealth）应用程序为T2D管理提供了补充策略，但它们对临床结果的影响尚不清楚。目的：本研究评估了临床实践中提倡“少坐多动”的移动健康计划对患有T2D的办公室员工的临床和心血管风险因素的影响。方法：一项随机对照试验将常规护理（n = 25）与使用Walk@Work-App和基于网络的工具进行为期13周的mHealth干预（n = 29）进行比较。结果包括HbA1c、血糖、血脂、特定领域的久坐行为（Workforce Sitting Questionnaire）、客观体力活动和久坐行为（ActivPal）、基线、6个月和12个月时的血压和BMI。结果：与对照组和12个月时相比，干预组的HbA1c显著降低（p ）。结论：移动健康计划有效地减少了久坐行为，改善了HbA1c和血压，是一种具有成本效益的t2dm成人生活方式干预。试验注册：ClinicalTrials.gov NCT04092738.https://clinicaltrials.gov/ct2/show/NCT04092738。

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引用次数: 0

Racial and ethnic differences in prescribing antihyperglycemic medications to persons with type 2 diabetes: An all of us cohort study 2型糖尿病患者抗高血糖药物处方的种族差异：一项我们所有人的队列研究。

IF 2.3 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-10-01 Epub Date: 2025-06-03 DOI: 10.1016/j.pcd.2025.05.011

Veronica J. Brady , Samuel Akyirem , Nikhil Padhye

Aims

This study aimed to determine prescribing patterns for newer antihyperglycemic agents among racial and ethnic minorities with type 2 diabetes (T2DM) using the All of Us study data.

Methods

We conducted a cross-sectional analysis of electronic health records (EHR) data obtained from the All of Us research study data. We included data from 20,016 persons with T2DM. Participants were eligible for the study if they were 18 years or older, living with T2DM, and had complete data on all variables of interest.

Results

Participants in the study were more likely to be > 55 years of age, identify as female, and non-Hispanic White. Nearly half of the participants were married or partnered and had a household income of less than $35,000 annually. Most participants had hypertension and obesity. Non-Hispanic Blacks had 14 % less odds of having a current or previous prescription of SGLT-2i and 28 % lower odds of receiving a prescription for a GLP-1RA.

Conclusions

Despite known benefits to mitigating the risk for cardiorenal complications related to diabetes, there continue to be disparities in the prescribing of newer antihyperglycemic medications for racial and ethnic minorities.

目的：本研究旨在利用All of Us研究数据，确定少数种族和民族2型糖尿病（T2DM）患者新型降糖药的处方模式。方法：我们对从“我们所有人”研究数据中获得的电子健康记录（EHR）数据进行了横断面分析。我们纳入了20,016例T2DM患者的数据。如果参与者年满18岁或以上，患有2型糖尿病，并且对所有感兴趣的变量有完整的数据，则他们有资格参加研究。结果：研究参与者更有可能是b> 55岁，女性和非西班牙裔白人。近一半的参与者已婚或有伴侣，家庭年收入低于3.5万美元。大多数参与者患有高血压和肥胖。非西班牙裔黑人目前或以前服用SGLT-2i的几率低14% %，服用GLP-1RA的几率低28% %。结论：尽管已知可以降低与糖尿病相关的心肾并发症的风险，但在种族和少数民族的新型降糖药物处方上仍然存在差异。

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引用次数: 0

A primary care guide to the screening and pharmacologic management of chronic kidney disease in people living with type 2 diabetes 2型糖尿病患者慢性肾脏疾病筛查和药物治疗的初级保健指南

IF 2.3 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-10-01 Epub Date: 2025-07-10 DOI: 10.1016/j.pcd.2025.05.005

Eugene E. Wright , Ana Cebrian , Daniel Ngui

This paper reports the expert opinions and recommendations made by primary care physicians (PCPs) to optimize screening and management of chronic kidney disease (CKD) associated with diabetes and presents algorithms to provide a practical and simplified guide for PCPs. Individuals living with type 2 diabetes (T2D) should be screened early and at regular intervals for CKD using both estimated glomerular filtration rate and urinary albumin-to-creatinine ratio testing. The risk of CKD assessed using the Kidney Disease: Improving Global Outcomes heatmap should be reviewed at least annually to optimize treatment to slow progression of CKD. Lifestyle modifications form the foundation of reducing CKD risk in individuals with T2D. A pillared approach to pharmacotherapy (renin–angiotensin system inhibitors, sodium-glucose cotransporter 2 inhibitors, a nonsteroidal mineralocorticoid receptor antagonist [finerenone], and glucagon-like peptide-1 receptor agonists) is recommended in individuals with CKD and T2D.

本文报道了初级保健医生（pcp）对优化糖尿病相关慢性肾脏疾病（CKD）筛查和管理的专家意见和建议，并提出了算法，为pcp提供实用和简化的指南。2型糖尿病（T2D）患者应通过肾小球滤过率和尿白蛋白与肌酐比值检测，尽早并定期筛查CKD。使用肾脏疾病评估CKD的风险：改善全球结果热图应至少每年进行一次审查，以优化治疗以减缓CKD的进展。生活方式的改变是降低T2D患者CKD风险的基础。推荐在CKD和T2D患者中使用药物治疗（肾素-血管紧张素系统抑制剂，钠-葡萄糖共转运蛋白2抑制剂，非甾体矿皮质激素受体拮抗剂[细烯酮]和胰高血糖素样肽-1受体激动剂）。

引用次数: 0