National Centre for Diabetes and Endocrinology, PO Box 7948, Ain Zara, Tripoli, Libya,
Diabetes Ther. 2014 Jun;5(1):113-26. doi: 10.1007/s13300-014-0052-4. Epub 2014 Jan 30.
The aim of the study was to investigate the clinical safety and effectiveness of starting insulin aspart (aspart) therapy in people with type 2 diabetes mellitus (T2DM) as a sub-analysis of the multinational, non-interventional A1chieve study.
Insulin-naïve and insulin-experienced people with T2DM in routine clinical care starting aspart alone at baseline and continuing aspart alone, changing to biphasic insulin aspart 30 (aspart premix) or adding a basal insulin by study end, were included. Safety, tolerability, and efficacy were evaluated over 24 weeks.
Overall, 3,898 people started aspart at baseline. Of the 3,313 with 24-week data, 1,545 (46.6%) continued with aspart, 1,379 (41.6%) switched to aspart premix, and 214 (6.5%) added basal insulin, while the remainder switched to other regimens. No serious adverse drug reactions were reported. The proportion of participants reporting hypoglycemia decreased from baseline to week 24 in the aspart alone group (11.2% versus 4.1%, p < 0.001) and in the aspart + basal insulin group (13.1% versus 7.5%, p = 0.040), and was 3.7% at week 24 in the aspart premix group. The mean HbA1c decreased from baseline to week 24 (aspart: -2.1 ± 2.0% [-23 ± 22 mmol/mol], aspart premix: -2.3 ± 1.7% [-25 ± 19 mmol/mol], aspart + basal insulin: -2.0 ± 2.1% [-22 ± 23 mmol/mol]; p < 0.001).
Insulin aspart therapy was well tolerated and was associated with improved glucose control over 24 weeks in people with T2DM.
本研究的目的是通过对多国、非干预性 A1chieve 研究的亚分析,调查起始胰岛素Aspart(Aspart)治疗 2 型糖尿病(T2DM)患者的临床安全性和有效性。
在常规临床护理中,起始胰岛素 Aspart 治疗且无胰岛素治疗史或有胰岛素治疗史的 T2DM 患者,基线时单独起始胰岛素 Aspart,研究结束时继续单独起始胰岛素 Aspart、转换为双相胰岛素 Aspart 30(Aspart 预混)或添加基础胰岛素,评估 24 周时的安全性、耐受性和疗效。
总体而言,3898 人在基线时起始胰岛素 Aspart。在有 24 周数据的 3313 人中,1545 人(46.6%)继续使用胰岛素 Aspart,1379 人(41.6%)转换为胰岛素 Aspart 预混,214 人(6.5%)添加基础胰岛素,其余人转换为其他方案。未报告严重药物不良反应。与基线相比,单独使用胰岛素 Aspart 组(11.2%比 4.1%,p<0.001)和胰岛素 Aspart+基础胰岛素组(13.1%比 7.5%,p=0.040)报告低血糖的参与者比例在 24 周时下降,胰岛素 Aspart 预混组 24 周时的平均 HbA1c 为 3.7%。与基线相比,24 周时(胰岛素 Aspart:-2.1±2.0%[-23±22mmol/mol];胰岛素 Aspart 预混:-2.3±1.7%[-25±19mmol/mol];胰岛素 Aspart+基础胰岛素:-2.0±2.1%[-22±23mmol/mol];p<0.001),HbA1c 降低。
在 24 周内,胰岛素 Aspart 治疗耐受性良好,与 T2DM 患者的血糖控制改善相关。