Diabetes Obes Metab:不同基础胰岛素治疗2型糖尿病 血糖控制有何不同?

2017-09-05 石岩 环球医学

2017年8月,发表在《Diabetes Obes Metab》的一项由中国、澳大利亚和美国科学家进行的观察性研究,比较了真实世界中不同基础胰岛素治疗(BI,包括中效胰岛素、甘精胰岛素和地特胰岛素)的有效性和安全性。



2017年8月,发表在《Diabetes Obes Metab》的一项由中国、澳大利亚和美国科学家进行的观察性研究,比较了真实世界中不同基础胰岛素治疗(BI,包括中效胰岛素、甘精胰岛素和地特胰岛素)的有效性和安全性。

目的:在真实世界临床环境中基于大规模注册研究,比较不同BI治疗的血糖控制和安全性。

方法:在本项多中心、为期6个月的前瞻性、观察性研究中,纳入了来自中国8个地区的209家医院中的2型糖尿病患者(糖化血红蛋白[HbA1c?]≥7%),口服抗糖尿病药物(OADs)血糖控制不佳并愿意开始BI治疗。BI的类型和剂量由医生的判断和患者的意愿决定。访谈在0个月(随访1)、3个月(随访2)和6个月(随访3)时进行。结局包括从基线到6个月时的HbA1c、低血糖发生率和体重的变化。

结果:总共16341和9002名受试者分别参与了意向治疗(ITT)和符合方案集(PP)分析。PS回归调整后,ITT分析显示甘精胰岛素组(2.2%±2.1%)和地特胰岛素组(2.2%±2.1%)的HbA1c降低值高于中效胰岛素组(2.0%?±?2.2%)(P<0.01)。与甘精胰岛素组(+0.1±3.0 kg)和中效胰岛素(+0.3±3.1 kg)组相比,地特胰岛素组体重增加最小(-0.1±2.9 kg)(P<0.05)。甘精胰岛素组轻微低血糖的发生率最低,而3组间严重低血糖的发生率无差异。PP分析观察到的结果与ITT分析结果一致。

结论:在中国的真实世界的临床环境中,与中效胰岛素治疗2型糖尿病患者相比,使用长效胰岛素类似物治疗与更好的血糖控制及更少的低血糖发生和体重增加相关。然而,这些观察的临床意义必须谨慎解释。

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2017, time=2017-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=240799, encodeId=9ed5240e9909, content=学习了.受益匪浅., beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Tue Sep 05 20:01:41 CST 2017, time=2017-09-05, status=1, ipAttribution=)]
    2017-10-06 guojianrong
  5. 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2017, time=2017-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=240799, encodeId=9ed5240e9909, content=学习了.受益匪浅., beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Tue Sep 05 20:01:41 CST 2017, time=2017-09-05, status=1, ipAttribution=)]
  6. 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2017, time=2017-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=240799, encodeId=9ed5240e9909, content=学习了.受益匪浅., beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Tue Sep 05 20:01:41 CST 2017, time=2017-09-05, status=1, ipAttribution=)]
    2018-01-31 baoya
  7. 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    2017-09-05 131****1460

    学习了.受益匪浅.

    0

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