背景：糖尿病是國人最重要的慢性病之一，已有相當多的臨床研究證實，長期良好血糖控制，可以減緩併發症之發生，但絕大部分的糖尿病需藉助藥物治療。而糖尿病隨著病程進展，越來越不容易控制，對於降血糖藥物使用種類和劑量調整，與糖尿病血糖控制情形國內尚無資料，於是設計本研究。
方法：於中部某醫學中心新陳代謝科，選擇自91年08月15日至94年05月31日期間，參與健保局糖尿病個案管理之第2型糖尿病門診病患，完成一年度及二年度複診之個案為研究對象。針對病患之空腹血糖值、糖化血色素及藥物使用情形，加以統計分析並做比較。共有1,375位病患收案滿一年度列為A組，其中455位病患收案滿二年度則列為B組。我們將藥物分成胰島素分泌促進劑、雙胍類、α糖分解抑制劑、胰島素增敏劑及胰島素共五類。
結果： 糖化血色素：A組收案時與滿一年度相比，有意義的下降，（8.19 ± 0.05 vs. 7.95 ± 0.04%，p < 0.001）。於B組患者比較其收案、滿一年及滿二年時之糖化血色素，滿一年較收案時雖有下降，並無統計學上之差異，而其中滿二年者卻比滿一年者呈現有意義的上升（8.00 ± 0.07 vs. 7.91 ± 0.07 vs. 8.12 ± 0.08%，p < 0.001）。空腹血糖值（mg/dl）的變化於A組或B組皆無統計學上之差異。
藥物種類：於A組患者其收案時與滿一年度相比，呈現有意義的增加（1.65 ± 0.02 vs. 1.71 ± 0.02，p < 0.001）；而B組其藥物種類也有增加的情形（1.70 ± 0.03 vs. 1.79 ± 0.03 vs. 1.80 ± 0.03 ，p < 0.001）。至於各種口服降血糖藥物劑量調整，我們無法獲得一致性的結論。
結論：糖尿病病人的降血糖藥物使用種類隔年有增加的情形，治療初期血糖呈現短暫下降但之後又上昇，主要因糖尿病是慢性進行性的疾病，需要使用較多種降血糖藥物，才能達到有效控制血糖。

Background: Type 2 diabetes mellitus (DM) is one of the major chronic diseases in Taiwan. Previous reports indicated that the complications of DM may be delayed if the blood sugar is well-controlled. However, the number and dosage of anti-diabetic drugs used in association with diabetic control are rarely reported.
Methods: A total of 1375 type 2 DM patients who participated in the Diabetes Share Care Disease Management (DSCDM) program in a medical center at central Taiwan from August 2002 to May 2005 was enrolled. Those 1375 patients received a completed follow-up studies in one-year period (defined as group A); 455 patients of them completed follow-up studies in 2-year period (defined as group B). 
Results: The HbA1C level in group A patients significantly reduced (8.19 ± 0.05% at the beginning vs. 7.95 ± 0.04% at the end of 1-year period, p < 0.001). However, in group B patients, the HbA1C level at the end of 2-year period was significantly greater than that at the end of 1-year period (8.00± 0.07% vs. 7.91 ± 0.07 vs. 8.12 ± 0.08%，p < 0.001).There were no significant difference of fasting blood sugar (FBS, mg/dl) level changes at the beginning, the end of 1-year and 2-year treatment in both A and B groups.
The number of anti-diabetic drugs significantly increased both in group A (1.65 ± 0.02 at the beginning vs. 1.71 ± 0.02 at the end of 1-year period，p < 0.001), and group B (1.70 ± 0.03 at the beginning vs. 1.79 ± 0.03 at the end of 1-year period vs. 1.80 ± 0.03 at the end of 2-year period, p < 0.001). The value of HbA1C became high as the number of anti-diabetic drugs increased.
Conclusion: The number of anti-diabetic agents used increased progressively in the end of one and two years. However, the trend did not coincide with alteration of glucose control in diabetes, probably resulting from adding more anti-diabetic agents along with progressive deterioration of blood glucose.