Rosenstock Julio, Bergenstal Richard, Defronzo Ralph A, Hirsch Irl B, Klonoff David, Boss Anders H, Kramer David, Petrucci Richard, Yu Wen, Levy Brian
Dallas Diabetes and Endocrine Center at Medical City, Dallas, Texas, USA.
Diabetes Care. 2008 Nov;31(11):2177-82. doi: 10.2337/dc08-0315. Epub 2008 Aug 4.
This double-blind, placebo-controlled, randomized, multicenter, parallel-group study compared the efficacy, safety, and tolerability of Technosphere insulin with Technosphere powder as placebo in insulin-naive type 2 diabetic patients whose diabetes was suboptimally controlled with oral antidiabetic agents.
Patients (n = 126) were randomly assigned to 12 weeks of therapy with Technosphere insulin or Technosphere powder after lifestyle education on nutrition, exercise, and instructions on inhaler use. The primary efficacy outcome was change in A1C from baseline to study end, and the secondary efficacy outcome was area under the curve for postprandial glucose levels during a meal test at treatment weeks 4, 8, and 12.
A1C reduction from a mean baseline of 7.9% was greater with Technosphere insulin than with Technosphere powder (-0.72 vs. -0.30%; P = 0.003). Postprandial glucose excursions were reduced by 56% with Technosphere insulin compared with baseline, and maximal postprandial glucose levels were reduced by 43% compared with Technosphere powder. Incidences of hypoglycemia, hyperglycemia, cough, and other adverse events were low in both groups. Body weight was unchanged in both groups.
Technosphere insulin was well tolerated and demonstrated significant improvement in glycemic control with clinically meaningful reductions in A1C levels and postprandial glucose concentrations after 12 weeks of treatment.
本双盲、安慰剂对照、随机、多中心、平行组研究比较了在口服抗糖尿病药物治疗效果欠佳的初治2型糖尿病患者中,Technosphere胰岛素与作为安慰剂的Technosphere粉末的疗效、安全性和耐受性。
患者(n = 126)在接受营养、运动方面的生活方式教育以及吸入器使用指导后,被随机分配接受为期12周的Technosphere胰岛素或Technosphere粉末治疗。主要疗效指标是糖化血红蛋白(A1C)从基线到研究结束时的变化,次要疗效指标是在治疗第4、8和12周的进餐试验期间餐后血糖水平的曲线下面积。
Technosphere胰岛素组的A1C从平均基线水平7.9%的降低幅度大于Technosphere粉末组(-0.72%对-0.30%;P = 0.003)。与基线相比,Technosphere胰岛素使餐后血糖波动降低了56%,与Technosphere粉末相比,餐后血糖最高水平降低了43%。两组低血糖、高血糖、咳嗽及其他不良事件的发生率均较低。两组体重均未改变。
Technosphere胰岛素耐受性良好,在治疗12周后,糖化血红蛋白水平和餐后血糖浓度有临床意义的降低,血糖控制得到显著改善。