Suzuki Daisuke, Umezono Tomoya, Miyauchi Masaaki, Kimura Moritsugu, Yamamoto Naoyuki, Tanaka Eitaro, Kuriyama Yusuke, Sato Hiroki, Miyatake Han, Kondo Masumi, Toyoda Masao, Fukagawa Masafumi
Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
Tokai J Exp Clin Med. 2012 Jul 20;37(2):41-6.
To determine the clinical usefulness of basal-supported oral therapy (BOT) using insulin glargine in Japanese patients with type 2 diabetes.
We compared HbA1c levels, body weight, and insulin doses before the introduction of BOT and in the final month of the observation period in 122 patients with type 2 diabetes who received BOT with insulin glargine between October 2007 and July 2009. To exclude the possible effects of seasonal changes in glycemic control, 57 of the 122 patients were followed-up for one year and examined for changes in HbA1c levels, body weight, and insulin dose.
Examination of all cases (n=122) showed a significant decrease in HbA1c (before BOT: 8.7±1.8, after: 7.1±1.1%), but no significant change in body weight (before: 63.1±16.1, after: 63.8±17.0 kg). The mean observation period was 10.5±6.4 months. Insulin doses were significantly increased during the study. HbA1c levels improved significantly in patients on non-insulin-secreting drugs (biguanide, α-glucosidase inhibitor and thiazolidine derivatives) than those on insulin-secreting drugs (SU agents and glinides).
BOT with insulin glargine is a useful strategy that can achieve good glycemic control in clinical practice without causing serious hypoglycemia. The introduction of BOT before exhaustion of pancreatic β cells may increase its effectiveness.
确定在日本2型糖尿病患者中使用甘精胰岛素的基础支持口服疗法（BOT）的临床实用性。
我们比较了2007年10月至2009年7月期间接受甘精胰岛素BOT治疗的122例2型糖尿病患者在引入BOT之前和观察期最后一个月时的糖化血红蛋白（HbA1c）水平、体重和胰岛素剂量。为排除血糖控制季节性变化的可能影响，对122例患者中的57例进行了为期一年的随访，并检查了HbA1c水平、体重和胰岛素剂量的变化。
对所有病例（n = 122）的检查显示，HbA1c显著降低（BOT前：8.7±1.8，之后：7.1±1.1%），但体重无显著变化（之前：63.1±16.1，之后：63.8±17.0 kg）。平均观察期为10.5±6.4个月。研究期间胰岛素剂量显著增加。与使用促胰岛素分泌药物（磺脲类药物和格列奈类药物）的患者相比，使用非促胰岛素分泌药物（双胍类、α-葡萄糖苷酶抑制剂和噻唑烷二酮衍生物）的患者HbA1c水平改善更为显著。
甘精胰岛素BOT是一种有用的策略，在临床实践中可实现良好的血糖控制且不会引起严重低血糖。在胰腺β细胞耗竭之前引入BOT可能会提高其有效性。
