COWI A/S, Parallelvej 2, Kongens Lyngby, DK-2800, Denmark.
BMC Endocr Disord. 2012 Sep 25;12:21. doi: 10.1186/1472-6823-12-21.
The uncertainties regarding dose similarities between basal long-acting insulin analogues remain. Recent real-world studies indicate dose similarities between insulin detemir and insulin glargine, but further studies are still warranted.The aim of this study was to compare real-life daily doses of insulin detemir and insulin glargine in type 2 diabetes patients when administered once daily.
We analysed 536 patient cases from general practice (63%) and endocrinological outpatient clinics (37%). A self-administered questionnaire completed by the treating physician was used to obtain data on patient characteristics (gender, age, weight, height, latest HbA1c-value), daily doses, administration of and number of years treated with insulin detemir and insulin glargine, concomitant insulin use and use of non-insulin anti-diabetic medication. Both bivariate analyses and multivariate regression analyses were applied to examine whether there were differences in the daily doses of insulin detemir and insulin glargine.
There was no significant difference in the mean daily doses of insulin detemir (0.414 U/kg) and insulin glargine (0.416 U/kg) (p = 0.4341). In multivariate regression analyses, age and BMI had a significant influence on daily insulin dose with the dose increasing 0.003 U/kg (p = 0.0375) and 0.008 U/kg (p = 0.0003) with every 1 increment in age and BMI, respectively.
Dose similarities between insulin detemir and insulin glargine were seen in type 2 diabetes patients when administered once daily. Thus, the use of insulin detemir and insulin glargine is not associated with different medical costs if the price and treating algorithm are similar.
基础长效胰岛素类似物之间剂量相似性的不确定性仍然存在。最近的真实世界研究表明，胰岛素地特胰岛素和甘精胰岛素之间存在剂量相似性，但仍需要进一步研究。本研究旨在比较每日一次给予时 2 型糖尿病患者使用胰岛素地特胰岛素和甘精胰岛素的实际日剂量。
我们分析了来自普通诊所（63%）和内分泌科门诊（37%）的 536 例患者病例。通过治疗医生填写的自我管理问卷来获取患者特征（性别、年龄、体重、身高、最近的 HbA1c 值）、胰岛素地特胰岛素和甘精胰岛素的日剂量、治疗年数、合并胰岛素使用情况和非胰岛素抗糖尿病药物使用情况的数据。应用双变量分析和多变量回归分析来检查胰岛素地特胰岛素和甘精胰岛素的日剂量是否存在差异。
胰岛素地特胰岛素（0.414 U/kg）和甘精胰岛素（0.416 U/kg）的平均日剂量无显著差异（p=0.4341）。多变量回归分析中，年龄和 BMI 对胰岛素剂量有显著影响，年龄每增加 1 岁，剂量增加 0.003 U/kg（p=0.0375），BMI 每增加 1 个单位，剂量增加 0.008 U/kg（p=0.0003）。
每日一次给予时，2 型糖尿病患者使用胰岛素地特胰岛素和甘精胰岛素的剂量相似。因此，如果价格和治疗方案相似，使用胰岛素地特胰岛素和甘精胰岛素不会导致不同的医疗费用。
