Perusicová J, Haladová I, Pit'hová P, Acsová D, Belobrádková J, Belzová A, Berková K, Dolezalová B, Dvoráková H, Hejnicová K, Hudcová M, Kallmünzerová D, Krejsová Z, Markofová G, Müllerová H, Owen K, Pelikánová M, Raclavská L, Racická E, Skarpová O, Váchová A, Veselá A, Vyoralos J, Broz J, Edelsberger T, Honka M, Hrdina T, Chmura P, Tosovský J
Interní klinika 2. Iékarské fakulty UK a FN Motol Praha.
Vnitr Lek. 2013 Mar;59(3):165-71.
BIBY STUDY OBJECTIVE: To obtain experience with exenatide treatment (Byetta) in patients with diabetes mellitus type 2 in a common clinical practice ofdiabetology departments. TYPE OF OBSERVATION: Observational study conducted by a randomly selected group of outpatient medical practitioners from 28 diabetology departments in the Czech Republic. OBSERVED AND ASSESSED POPULATION: 465 patients underwent at least three months of Byetta treatment; 347 persons (74.6% ofthe research population) stayed forthe extended observation of 6-12 months. Apart from the basic identification data (year of birth, sex, age when diabetes mellitus manifested, height, maximum patient weight before diabetes and when diabetes mellitus manifested), the following information was recorded in three-month intervals: weight, waistline, glycated haemoglobin (HbA(1c)), and diabetes mellitus treatment The population included 50.3% women and 49.7% men, and the average age at the time of diabetes manifestation was 48 (20-73 years). The period between the diabetes manifestation and the start of exenatide treatment was 8.3 years on average.
The average maximum BMI value before the detection of diabetes was 39.05 (+/- 6.73); at the time of the diabetes manifestation 37.88 (+/- 6.40); and at the start of Byetta treatment 39.01 (+/- 6.22). The BMI after three, six, and 12 months of treatment was as follows: 37.86 (+/- 6.12), 37.18 (+/- 6.0), and 36.60 (+/- 6.21); it decreased by > or = 0.5 in 83.3% patients who were under observation for 12 months. HbA(1c) value decreased in the first three months from 7.39% (+/- 1.57) to 6.41% (+/- 1.34), p < 0.0001. In the period of three-six months, the value decreased to 6.22% (+/- 1.34), and after 12 months, HbA(1c) was at 6.04 (+/- 1.20). An improvement in HbA(1c) value of 0.5-2.0% occurred after the first year in 49% of our research population. The waistline was measured on a regular basis in only 267 patients (58.9%). The average initial value of 120.7 cm was reduced within three months of the treatment to 118.3 cm, and within six and 12 months to 117.3 and 112.6 cm respectively.
Adding Byetta to the currently applied treatment of obese patients with diabetes mellitus type 2 led, in 66.8% of the population, to a statistically significant reduction in HbA(1c) levels in the first three-six months of the treatment; after 12 months of treatment, 25% of the population was still showing an improvement in HbA(1c) of > 2.0%. Of observed patients, 74.4% significantly reduced their BMI (by > 0.5) during the first three months; 39.6% of patients reduced their BMI in the period of three-six months.
BIBY研究目的:在糖尿病科的常规临床实践中获取使用艾塞那肽(百泌达)治疗2型糖尿病患者的经验。观察类型:由捷克共和国28个糖尿病科随机挑选的一组门诊医生进行的观察性研究。观察和评估人群:465例患者接受了至少三个月的百泌达治疗;347人(占研究人群的74.6%)进行了6 - 12个月的延长观察。除了基本识别数据(出生年份、性别、糖尿病发病时的年龄、身高、糖尿病发病前及发病时的最大体重)外,还每隔三个月记录以下信息:体重、腰围、糖化血红蛋白(HbA₁c)以及糖尿病治疗情况。该人群中女性占50.3%,男性占49.7%,糖尿病发病时的平均年龄为48岁(20 - 73岁)。糖尿病发病与开始使用艾塞那肽治疗之间的平均时间为8.3年。
糖尿病检测前的平均最大体重指数(BMI)值为39.05(±6.73);糖尿病发病时为37.88(±6.40);开始使用百泌达治疗时为39.01(±6.22)。治疗3个月、6个月和12个月后的BMI分别为:37.86(±6.12)、37.18(±6.0)和36.60(±6.21);在接受12个月观察的患者中,83.3%的患者BMI下降≥0.5。HbA₁c值在最初三个月从7.39%(±1.57)降至6.41%(±1.34),p < 0.0001。在3 - 6个月期间,该值降至6.22%(±1.34),12个月后,HbA₁c为6.04(±1.20)。在我们的研究人群中,49%的患者在第一年之后HbA₁c值改善了0.5 - 2.0%。仅267例患者(58.9%)定期测量腰围。平均初始值120.7厘米在治疗三个月内降至118.3厘米,在六个月和12个月时分别降至117.3厘米和112.6厘米。
在目前对肥胖的2型糖尿病患者的治疗中添加百泌达,在治疗的前3 - 6个月,66.8%的人群中糖化血红蛋白(HbA₁c)水平有统计学意义的降低;治疗12个月后,25%的人群糖化血红蛋白(HbA₁c)仍有>2.0%的改善。在观察的患者中,74.4%在最初三个月内BMI显著降低(>0.5);39.6%的患者在3 - 6个月期间BMI降低。