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一项双盲交叉、开放标签试验,比较21名中国糖尿病患者使用胰岛素泵输注门冬胰岛素和诺和灵R的疗效和安全性。

A 2-way cross-over, open-labeled trial to compare efficacy and safety of insulin Aspart and Novolin R delivered with CSII in 21 Chinese diabetic patients.

作者信息

Bi Yu-fang, Zhao Lie-bin, Li Xiao-ying, Wang Wei-qing, Sun Shou-yue, Chen Yu-hong, Hong Jie, Su Ting-wei, Liu Jian-min, Ning Guang

机构信息

Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.

出版信息

Chin Med J (Engl). 2007 Oct 5;120(19):1700-3.

Abstract

BACKGROUND

Subcutaneous absorption is accelerated by the monomeric conformation of insulin Aspart, which provides good glycemic control with a lower risk of hypoglycemia and less body weight increase. In the present study we investigated the efficacy and safety of a rapid-acting human insulin analogue (insulin Aspart) delivered with continuous subcutaneous insulin infusion (CSII) into Chinese diabetic patients.

METHODS

A total of 21 patients with type 1 or type 2 diabetes were recruited for the 2-way cross-over, open-labeled trial, and then randomized to Group A (n = 10, treated with insulin Aspart) or Group B (n = 11, treated with Novolin R). Insulin Aspart and Novolin R were administered by CSII. Capillary glucose concentrations were measured at 8 time points, pre-prandial and postprandial, bedtime (10 pm), midnight (2 am) every day during the treatment.

RESULTS

The average capillary glucose profiles for the day were much better controlled in Group A than in Group B (P < 0.01). The blood glucose levels were particularly better controlled in Group A than in Group B at pre-breakfast ((6.72 +/- 1.24) mmol/L vs (7.84 +/- 1.58) mmol/L, P = 0.014), post-breakfast ((8.96 +/- 2.41) mmol/L vs (11.70 +/- 3.11) mmol/L, P = 0.0028), post-supper ((8.15 +/- 2.10) mmol/L vs (10.07 +/- 2.36) mmol/L, P = 0.008), bed time ((7.73 +/- 1.72) mmol/L vs (9.39 +/- 2.05) mmol/L, P = 0.007) and midnight ((6.32 +/- 1.16) mmol/L vs (7.48 +/- 1.36) mmol/L, P = 0.0049). There was no significant difference in the frequency of hypoglycemic episodes between the two groups.

CONCLUSION

Insulin Aspart results in better control of blood glucose levels than regular human insulin (Novolin R) in diabetic patients during delivery by CSII.

摘要

背景

门冬胰岛素的单体构象可加速皮下吸收,其能实现良好的血糖控制,低血糖风险较低且体重增加较少。在本研究中,我们调查了通过持续皮下胰岛素输注(CSII)给中国糖尿病患者使用速效人胰岛素类似物(门冬胰岛素)的疗效和安全性。

方法

共招募21例1型或2型糖尿病患者进行双向交叉、开放标签试验,然后随机分为A组(n = 10,接受门冬胰岛素治疗)或B组(n = 11,接受诺和灵R治疗)。通过CSII给予门冬胰岛素和诺和灵R。在治疗期间,每天于8个时间点测量毛细血管血糖浓度,包括餐前、餐后、就寝时间(晚上10点)、午夜(凌晨2点)。

结果

A组一天的平均毛细血管血糖曲线控制情况明显优于B组(P < 0.01)。早餐前((6.72 ± 1.24) mmol/L 对 (7.84 ± 1.58) mmol/L,P = 0.014)、早餐后((8.96 ± 2.41) mmol/L 对 (11.70 ± 3.11) mmol/L,P = 0.0028)、晚餐后((8.15 ± 2.10) mmol/L 对 (10.07 ± 2.36) mmol/L,P = 0.008)、就寝时间((7.73 ± 1.72) mmol/L 对 (9.39 ± 2.05) mmol/L,P = 0.007)和午夜((6.32 ± 1.16) mmol/L 对 (7.48 ± 1.36) mmol/L,P = 0.0049)时,A组的血糖水平控制明显优于B组。两组低血糖发作频率无显著差异。

结论

在通过CSII给药时,门冬胰岛素比常规人胰岛素(诺和灵R)能更好地控制糖尿病患者的血糖水平。

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