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V-Go胰岛素输注装置在糖尿病控制欠佳患者中的应用:来自大型专业糖尿病系统的回顾性分析

Use of V-Go Insulin Delivery Device in Patients with Sub-optimally Controlled Diabetes Mellitus: A Retrospective Analysis from a Large Specialized Diabetes System.

作者信息

Lajara Rosemarie, Fetchick Dianne A, Morris Tracy L, Nikkel Carla

机构信息

Diabetes America, Plano, TX, USA.

Diabetes America, San Antonio, TX, USA.

出版信息

Diabetes Ther. 2015 Dec;6(4):531-545. doi: 10.1007/s13300-015-0138-7. Epub 2015 Oct 15.

Abstract

INTRODUCTION

Tight glycemic control and timely treatment can improve outcomes in patients with diabetes yet many remain sub-optimally controlled. The objective of the current study was to evaluate the effect of switching patients with sub-optimally controlled diabetes to the V-Go (Valeritas Inc., Bridgewater, NJ, USA) Disposable Insulin Delivery device.

METHODS

A retrospective analysis of electronic medical records was conducted to assess patients with sub-optimal glycemic control defined as a glycated hemoglobin (HbA1c) >7%, switched to V-Go. Blood glucose control defined as change from baseline in HbA1c, prescribed insulin doses, body weight, concomitant anti-hyperglycemic agents, and reported hypoglycemia were collected prior to switching to V-Go and during V-Go use.

RESULTS

Two-hundred and four patients were evaluated during the study period. Overall, there was a significant decrease in HbA1c after switching to V-Go at the 14- and 27-week follow-up visits. The least-squares mean (LSM) change in HbA1c (95% confidence interval) from baseline to 14 weeks was -1.53% (-1.69% to -1.37%; P < 0.001), and from baseline to 27 weeks was -1.79% (-1.97% to -1.61%; P < 0.001). Significant reductions in mean HbA1c were achieved at both visits in all patient subsets: Patients with type 2 and type 1/latent autoimmune diabetes in adults (LADA); patients using insulin at baseline and patients naïve to insulin at baseline. Patients administering insulin at baseline required significantly less insulin on V-Go (86-99 LSM units/day at baseline to 58 LSM units/day at 27 weeks; P < 0.001). Across all patients, reported hypoglycemic events were no more frequent on V-Go than on previous therapy.

CONCLUSION

V-Go is safe and effective in patients with sub-optimally controlled diabetes requiring insulin therapy. Glycemic control improved significantly, less insulin was required, and hypoglycemic events were similar after patients switched to insulin delivery by V-Go.

FUNDING

Valeritas, Inc.

摘要

引言

严格的血糖控制和及时治疗可改善糖尿病患者的预后,但仍有许多患者的血糖控制未达最佳水平。本研究的目的是评估将血糖控制欠佳的糖尿病患者改用V-Go(美国新泽西州布里奇沃特市Valeritas公司生产)一次性胰岛素输注装置的效果。

方法

对电子病历进行回顾性分析,以评估血糖控制欠佳(糖化血红蛋白[HbA1c]>7%)且改用V-Go的患者。收集改用V-Go之前及使用V-Go期间血糖控制情况的数据,包括HbA1c相对于基线的变化、胰岛素处方剂量、体重、同时使用的降糖药物以及报告的低血糖情况。

结果

在研究期间对204例患者进行了评估。总体而言,在14周和27周的随访中,改用V-Go后HbA1c显著降低。HbA1c从基线到14周的最小二乘均值(LSM)变化(95%置信区间)为-1.53%(-1.69%至-1.37%;P<0.001),从基线到27周为-1.79%(-1.97%至-1.61%;P<0.001)。在所有患者亚组的两次随访中,HbA1c均值均显著降低:2型糖尿病患者以及成人隐匿性自身免疫性糖尿病(LADA)患者;基线时使用胰岛素的患者和基线时未使用过胰岛素的患者。基线时使用胰岛素的患者在使用V-Go时所需胰岛素显著减少(基线时为86 - 99 LSM单位/天,27周时为58 LSM单位/天;P<0.001)。在所有患者中,报告的低血糖事件在使用V-Go时并不比之前的治疗更频繁。

结论

对于血糖控制欠佳且需要胰岛素治疗的糖尿病患者,V-Go安全有效。改用V-Go进行胰岛素输注后,血糖控制显著改善,所需胰岛素减少,低血糖事件发生率相似。

资助

Valeritas公司

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd9e/4674471/bc24f95ba617/13300_2015_138_Fig1_HTML.jpg

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