Endocrinology Section, Department of Internal Medicine, Prince Hamzah Hospital, Amman, Jordan.
Diabetes Ther. 2013 Dec;4(2):309-19. doi: 10.1007/s13300-013-0032-0. Epub 2013 Jul 12.
This sub-analysis of the A1chieve study evaluated the safety and effectiveness of changing from a basal-only insulin regimen to biphasic insulin aspart 30.
A1chieve was an international, multicenter, prospective, open-label, non-interventional, 24-week study in people with type 2 diabetes mellitus starting/switching to therapy with biphasic insulin aspart 30, insulin detemir, or insulin aspart (alone/in combination) in routine clinical practice. This sub-analysis evaluated the safety and effectiveness of switching from basal insulin with either insulin glargine (GLA group) or insulin neutral protamine Hagedorn (NEU group) to biphasic insulin aspart 30.
A total of 2,818 participants received biphasic insulin aspart 30 (1,395 in the GLA group and 1,423 in the NEU group). After 24 weeks of treatment, there were significant reductions in the proportion of patients with at least one hypoglycemia event: total [baseline vs. 24 weeks: 15.5% vs. 9.7% (p < 0.001) and 12.3% vs. 9.9% (p < 0.05), in NEU and GLA groups, respectively], major [2.5% vs. 0.08% (p < 0.001) and 1.2% vs. 0.08% (p < 0.001), in NEU and GLA groups, respectively] and nocturnal hypoglycemia [7.2% vs. 3.5% (p < 0.001) and 5.4% vs. 3.9% (p < 0.05), in NEU and GLA groups, respectively]. After 24 weeks of biphasic insulin aspart 30 there were statistically significant improvements from baseline in glycated hemoglobin, fasting plasma glucose, and post-prandial plasma glucose levels (p < 0.001) and in health-related quality of life (p < 0.001) in both groups.
Biphasic insulin aspart 30 may benefit patients with poor glycemic control on basal insulin regimens who are seeking to change treatment.
本项 A1chieve 研究的亚组分析评估了将基础胰岛素方案转换为双时相门冬胰岛素 30 的安全性和有效性。
A1chieve 是一项国际性、多中心、前瞻性、开放性、非干预性、为期 24 周的研究,纳入了起始/转换接受双时相门冬胰岛素 30、地特胰岛素或门冬胰岛素(单独或联合)治疗的 2 型糖尿病患者。本亚组分析评估了将基础胰岛素(甘精胰岛素[GLA]组或中性鱼精蛋白锌胰岛素[NEU]组)转换为双时相门冬胰岛素 30 的安全性和有效性。
共有 2818 名患者接受了双时相门冬胰岛素 30 治疗(GLA 组 1395 例,NEU 组 1423 例)。治疗 24 周后,至少发生 1 次低血糖事件的患者比例显著降低:总体[基线 vs. 24 周:15.5% vs. 9.7%(p<0.001)和 12.3% vs. 9.9%(p<0.05),在 NEU 和 GLA 组]、重度[2.5% vs. 0.08%(p<0.001)和 1.2% vs. 0.08%(p<0.001),在 NEU 和 GLA 组]和夜间低血糖[7.2% vs. 3.5%(p<0.001)和 5.4% vs. 3.9%(p<0.05),在 NEU 和 GLA 组]。接受双时相门冬胰岛素 30 治疗 24 周后,两组患者的糖化血红蛋白、空腹血糖和餐后血糖水平均较基线显著改善(p<0.001),健康相关生活质量也显著改善(p<0.001)。
对于血糖控制不佳且正在寻求改变治疗方案的基础胰岛素方案患者,双时相门冬胰岛素 30 可能带来获益。