胰島素增敏劑、二甲雙胍、磺醯尿素、胰島素在糖尿病併發症之療效評估

The effect and estimate by using thiazolidinediones、 Metformin、Sulfonylureas and Insulin for diabetes’s complication

簡德隆(Te-Lung Chien)

指導教授 ： 王賢達

國立臺北科技大學/工程學院/有機高分子研究所/碩士(2005年)

摘要

本研究根據民國87年至民國92年之全民健康保險資料庫，以ICD-9-CM疾病診斷碼，門診處方醫令明細檔以及住院醫療費用醫令清單明細檔，研究台灣糖尿病患者進行各項治療之頻率與盛行率；分析五年內曾經發生糖尿病、高血壓、急性心肌梗塞、心絞痛症、中風、視網膜病變、腎臟病變、及神經病變之糖尿病病人的資料，相對於各類藥品如胰島素增敏劑、雙胍類、磺醯尿素、胰島素之單獨與合併治療之交互影響。亦從經濟觀點，評估標準抗糖尿病治療(包含口服抗糖尿病用藥、注射胰島素)之藥效與生命延長之效果。
本研究分析顯示使用胰島素增敏劑合併其他用藥相對未使用胰島素增敏劑之病人平均生命比較14.97年 vs. 14.52年。胰島素增敏劑單獨處方時，可明顯降低HbA1c達2.6%，同時降低空腹血糖值高達95mg/dL；胰島素增敏劑用於合併療法時，可再進一步降低HbA1c達1.7%，同時再降低空腹血糖值高達68mg/dL。

關鍵字

糖尿病 ； 胰島素增敏劑 ； 二甲雙胍 ； 磺醯尿素 ； 胰島素

並列摘要

This study is a retrospective analysis of the 1998-2003 database from the National Health Insurance Bureau. Data retrieving is based on the ICD-9-Code and the details of prescriptions and expanses from the outpatient and inpatient departments. Incidence and prevalence of the Taiwan Diabetic epidemiological statistics are involved in the diabetic patient with the history of hypertension, acute myocardia infraction、 angina、 stroke、retinopathy、nephropathy、 neuropathy...etc. In comparison with various medications like insulin sensitizers、 biguanides、sulphonyureas and insulin. Financial prospective are taken into account to analyze the efficacy of all kinds of medications (oral anti-diabetics and insulin) and evaluate the impact for patients’ life extension.
Both for along or in combination with insulin senitizers therapy show longer life expectancy. In comparison of patient with and without insulin senitizers for diabetic treatments, life expectancies are 14.97 years and 14.52 years, respectively. Mono therapy by insulin senitizers for diabetic treatments, HbA1c is dropped for 2.6%； fasting blood glucose could be reduced up to 95mg/dL .Combination therapy with insulin senitizers for diabetic treatments, HbA1c can be further down about 1.7% and further reduced fasting glucose for another 68mg/dL.

並列關鍵字

Diabetes Mellitus ； Thiazolidinediones ； Metformin ； Sulfonylurea ； Insulin

參考文獻

台北：行政院衛生署，1986，1-14，83-86。

and projections. Diabetes Care 1998; 21: 1414-1431.

M.Global estimates for prevalence of diabetes mellitus

artery disease in non-insulin dependent diabetes

mellitus: United Kingdom Prospective Diabetes Study