Manini Rita, Forlani Gabriele, Moscatiello Simona, Zannoni Chiara, Marzocchi Rebecca, Marchesini Giulio
Unit of Metabolic Disease, Alma Mater Studiorum University of Bologna, S. Orsola Hospital, Via Massarenti 9, 40138 Bologna, Italy.
Nutr Metab Cardiovasc Dis. 2007 Sep;17(7):493-8. doi: 10.1016/j.numecd.2006.07.001. Epub 2006 Nov 28.
Glargine improves glucose control and reduces the risk of nocturnal hypoglycemia compared with neutral protamine Hagedorn (NPH) insulin. To date, only one study has measured the effects of glargine on health-related quality of life (HRQL); the aim of this study was therefore to confirm the beneficial effects of glargine on disease-specific HRQL in type 1 diabetes.
Forty-seven patients (mean age, 46 range, 25-74; males, 54%) with diabetes of at least 1-year duration, and with suboptimal glucose control under intensive insulin treatment (IIT), were switched from NPH to glargine. Forty patients maintained on IIT were used as controls. Diabetes-related HRQL was assessed using the Well-being Enquiry for Diabetics (WED), before and after a 6- to 8-month switch to glargine. An 11-item questionnaire based upon diabetes-specific issues was used to assess treatment satisfaction and perceived changes after switching. On glargine, the mean glycosylated hemoglobin decreased by 0.7% (treatment vs. baseline, P<0.0001) and several WED scores improved (discomfort, P=0.020; impact, P=0.0002; total score, P=0.0005). WED changes were associated with a lower perceived risk of hypoglycemia and less problems in daily life on glargine.
The results of this study show that the beneficial effect of glargine is not limited to better metabolic control; the burden of type 1 diabetes mellitus on everyday life is also reduced.
与中性精蛋白锌胰岛素(NPH)相比,甘精胰岛素可改善血糖控制并降低夜间低血糖风险。迄今为止,仅有一项研究测量了甘精胰岛素对健康相关生活质量(HRQL)的影响;因此,本研究的目的是证实甘精胰岛素对1型糖尿病患者特定疾病HRQL的有益作用。
47例糖尿病病程至少1年、在强化胰岛素治疗(IIT)下血糖控制欠佳的患者(平均年龄46岁,范围25 - 74岁;男性占54%),从NPH胰岛素转换为甘精胰岛素。40例维持IIT治疗的患者作为对照。在转换为甘精胰岛素6至8个月前后,使用糖尿病患者健康状况调查问卷(WED)评估与糖尿病相关的HRQL。采用一份基于糖尿病特定问题的11项问卷评估治疗满意度及转换后的感知变化。使用甘精胰岛素治疗后,糖化血红蛋白平均下降0.7%(治疗后与基线相比,P<0.0001),多项WED评分改善(不适,P = 0.020;影响,P = 0.0002;总分,P = 0.0005)。WED评分的变化与甘精胰岛素治疗时较低的低血糖感知风险及日常生活中较少的问题相关。
本研究结果表明,甘精胰岛素的有益作用不仅限于更好的代谢控制;1型糖尿病对日常生活的负担也有所减轻。