Pediatr Diabetes:TODAY试验中控制不佳的2型糖尿病青年对胰岛素治疗反应的预测因素

2020-10-05 MedSci原创 MedSci原创

本研究旨在探究TODAY研究中2型糖尿病青年在单用二甲双胍、二甲双胍+罗格列酮或二甲双胍+生活方式治疗后血糖失败(持续HbA1c≥8%),开始使用胰岛素后血糖控制的相关因素。

本研究旨在探究TODAY研究中2型糖尿病青年在单用二甲双胍、二甲双胍+罗格列酮或二甲双胍+生活方式治疗后血糖失败(持续HbA1c≥8%),开始使用胰岛素后血糖控制的相关因素。

研究人员评估了额外使用胰岛素治疗后HbA1c的变化和血糖反应的预测因素。在胰岛素启动后1年,253名青年自胰岛素启动后平均就诊3.9±1.0次。根据血糖控制情况将参与者分为三组:在75%或更多的访问中,HbA1c一致减少≥0.5%,变化<0.5%,或HbA1c一致增加≥0.5%。

 

结果显示,胰岛素启动后1年内,33.2%的参与者HbA1c下降≥0.5%,46.2%的参与者HbA1c变化<0.5%,20.6%的参与者HbA1c增加≥0.5%。在随机进入TODAY和开始使用胰岛素时,三个血糖组在年龄、性别、种族族、青春期阶段、BMI z-score、糖尿病持续时间、胰岛素分泌指数等方面相似。HbA1c的持续改善与随机化时和失败时较高的胰岛素敏感性(1/空腹胰岛素)、随机化时较高的脂肪蛋白有关,与β细胞功能指标无关。

 

综上所述,该研究结果表明,TODAY中青年对附加胰岛素的反应差异很大。随机化时更高的胰岛素敏感性和更高的脂肪蛋白浓度与开始使用胰岛素后血糖控制的改善有关。由于关于注射胰岛素依从性的信息有限,因此对依从规定的胰岛素治疗方案或社会心理因素的作用尚不清楚。

 

原始出处:

 

Fida BachaLaure El Ghormli, et al., Predictors of response to insulin therapy in youth with poorly-controlled type 2 diabetes in the TODAY trial. Pediatr Diabetes. 2019 Nov;20(7):871-879. doi: 10.1111/pedi.12906. 

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    2021-04-13 feather89
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    2021-06-16 baoya
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    2020-10-05 misszhang

    谢谢MedSci提供最新的资讯

    0

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    2020-10-05 ms9000002090057930

    急急急,好,很好

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