University of Indonesia, Cipto Mangunkusomo Hospital, Jakarta, Indonesia.
Diabetes Res Clin Pract. 2013 Apr;100 Suppl 1:S10-6. doi: 10.1016/S0168-8227(13)70004-4.
To determine the safety and effectiveness of insulin detemir (IDet) in type 2 diabetes patients from the ASEAN cohort of the A1chieve study.
Patients from Indonesia, Malaysia, Philippines and Singapore prescribed IDet at the discretion of their physicians were included. The primary outcome was the incidence of serious adverse drug reactions including major hypoglycaemia over 24 weeks. Secondary endpoints included changes in the frequency of hypoglycaemia, serious adverse events and effectiveness assessments.
This sub-analysis included 1540 patients (insulin-naive, 1239; insulin-experienced, 301) with mean age ± SD 56.4 ± 10.9 years, BMI 25.4 ± 4.6 kg/m(2) and diabetes duration 6.9 ± 5.3 years. Insulin-naive patients received a baseline IDet dose of 0.24 ± 0.11 U/kg titrated up to 0.37 ± 0.21 U/kg by Week 24. The pre-study insulin dose in insulin-experienced patients was 0.41 ± 0.25 U/kg and baseline IDet dose was 0.31 ± 0.24 U/kg titrated up to 0.40 ± 0.20 U/kg by Week 24. Overall hypoglycaemia decreased from 1.73 to 0.46 events/patient-year from baseline to Week 24 (change in proportion of patients affected, p < 0.0001). At Week 24, 1 major hypoglycaemic event was reported in 1 insulin-experienced patient. IDet significantly improved glucose control (p < 0.001) at Week 24. The lipid profile and systolic blood pressure improved (p < 0.001) and body weight did not change significantly. Quality of life was positively impacted (p < 0.001).
IDet was well-tolerated and improved glycaemic control without increasing the risk of hypoglycaemia or weight gain.
在 A1chieve 研究的东盟队列中,评估胰岛素地特胰岛素(IDet)在 2 型糖尿病患者中的安全性和有效性。
纳入了在医生的指导下处方 IDet 的来自印度尼西亚、马来西亚、菲律宾和新加坡的患者。主要结局为 24 周内严重药物不良反应(包括严重低血糖)的发生率。次要终点包括低血糖的发生频率、严重不良事件和疗效评估的变化。
本亚分析纳入了 1540 名患者(胰岛素初治患者 1239 例,胰岛素经治患者 301 例),平均年龄 ± 标准差为 56.4 ± 10.9 岁,BMI 为 25.4 ± 4.6 kg/m2,糖尿病病程为 6.9 ± 5.3 年。胰岛素初治患者起始 IDet 剂量为 0.24 ± 0.11 U/kg,至第 24 周时滴定至 0.37 ± 0.21 U/kg。胰岛素经治患者的预研究胰岛素剂量为 0.41 ± 0.25 U/kg,起始 IDet 剂量为 0.31 ± 0.24 U/kg,至第 24 周时滴定至 0.40 ± 0.20 U/kg。总体低血糖发生率从基线时的 1.73 降至 0.46 事件/患者年(受影响患者比例的变化,p < 0.0001)。至第 24 周时,1 例胰岛素经治患者发生 1 次严重低血糖事件。IDet 显著改善了第 24 周的血糖控制(p < 0.001)。血脂谱和收缩压改善(p < 0.001),体重无显著变化。生活质量受到积极影响(p < 0.001)。
IDet 具有良好的耐受性,改善了血糖控制,而不会增加低血糖或体重增加的风险。