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在A1chieve研究中,印度2型糖尿病患者从双相人胰岛素转换为门冬胰岛素30双相制剂的临床经验。

Clinical experience of switching from biphasic human insulin to biphasic insulin aspart 30 in Indian patients with type 2 diabetes in the A1chieve study.

作者信息

Das A K, Kalra Sanjay, Akhtar Shahid, Shetty Raman, Kumar Ajay

机构信息

Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

Department of Endocrinology, Bharti Hospital and B.R.I.D.E, Karnal, Haryana, India.

出版信息

Indian J Endocrinol Metab. 2015 Jan-Feb;19(1):110-5. doi: 10.4103/2230-8210.131759.

Abstract

AIM

The aim of the following study is to evaluate the safety and effectiveness of switching from biphasic human insulin (BHI) to biphasic insulin aspart 30 (BIAsp 30) in Indian patients with type 2 diabetes as a sub-analysis of the 24-week, non-interventional A1chieve study.

MATERIALS AND METHODS

Indian patients switching from BHI to BIAsp 30 based on the physicians' decisions were included. The primary outcome was the incidence of serious adverse drug reactions (SADRs), including major hypoglycemic events; secondary outcomes included changes in hypoglycemia in the 4 weeks preceding baseline and week 24 and changes from baseline to week 24 in glycated hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), postprandial plasma glucose (PPPG), body weight and quality of life (QoL).

RESULTS

Overall, 1976 patients (mean ± standard deviation age, 55.1 ± 10.6 years and diabetes duration, 10.1 ± 5.3 years) on a mean pre-study BHI dose of 0.44 ± 0.18 U/kg were included. The mean BIAsp 30 dose was 0.43 ± 0.17 U/kg at baseline and 0.44 ± 0.17 U/kg at week 24. No SADRs were reported. The proportion of patients reporting overall hypoglycemic events reduced significantly from baseline to week 24 (15.0% vs. 2.9%, P < 0.0001). The mean HbA1c level improved significantly from 9.1 ± 1.4% at baseline to 7.5 ± 1.0% at week 24, along with improvements in FPG, post-breakfast PPPG and QoL (P < 0.001). The mean body weight decreased from 69.3 ± 10.8 kg at baseline to 69.1 ± 10.4 kg at week 24 (P = 0.003).

CONCLUSION

Switching from BHI to BIAsp 30 therapy was well-tolerated and was associated with improved glycemic control.

摘要

目的

以下研究的目的是,作为一项为期24周的非干预性A1chieve研究的子分析,评估印度2型糖尿病患者从双相人胰岛素(BHI)转换为门冬胰岛素30双相制剂(BIAsp 30)的安全性和有效性。

材料与方法

纳入根据医生决定从BHI转换为BIAsp 30的印度患者。主要结局是严重药物不良反应(SADR)的发生率,包括严重低血糖事件;次要结局包括基线前4周和第24周低血糖的变化,以及糖化血红蛋白A1c(HbA1c)、空腹血糖(FPG)、餐后血糖(PPPG)、体重和生活质量(QoL)从基线到第24周的变化。

结果

总体上,纳入了1976例患者(平均±标准差年龄为55.1±10.6岁,糖尿病病程为10.1±5.3年),研究前BHI平均剂量为0.44±0.18 U/kg。基线时BIAsp 30平均剂量为0.43±0.17 U/kg,第24周时为0.44±0.17 U/kg。未报告SADR。报告总体低血糖事件的患者比例从基线到第24周显著降低(15.0%对2.9%,P<0.0001)。平均HbA1c水平从基线时的9.1±1.4%显著改善至第24周时的7.5±1.0%,同时FPG、早餐后PPPG和QoL也有所改善(P<0.001)。平均体重从基线时的69.3±10.8 kg降至第24周时的69.1±10.4 kg(P=0.003)。

结论

从BHI转换为BIAsp 30治疗耐受性良好,并与血糖控制改善相关。

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本文引用的文献

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IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030.
Diabetes Res Clin Pract. 2011 Dec;94(3):311-21. doi: 10.1016/j.diabres.2011.10.029. Epub 2011 Nov 12.
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Real-life dosage and clinical efficacy of biphasic insulin preparations in patients with type 2 diabetes.
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