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甘精胰岛素 300U/mL 与甘精胰岛素 100U/mL 治疗初诊 2 型糖尿病患者的血糖控制和低血糖:EDITION 3 研究 12 个月结果。

Glycaemic control and hypoglycaemia with insulin glargine 300U/mL versus insulin glargine 100U/mL in insulin-naïve people with type 2 diabetes: 12-month results from the EDITION 3 trial.

机构信息

Department of Medicine, Perugia University Medical School, Hospital Santa Maria della Misericordia, 06156 Perugia, Italy.

Oregon Health & Science University, Portland, OR, USA.

出版信息

Diabetes Metab. 2017 Sep;43(4):351-358. doi: 10.1016/j.diabet.2017.04.007. Epub 2017 Jun 13.

Abstract

AIM

To explore if efficacy and safety findings for insulin glargine 300U/mL (Gla-300) versus insulin glargine 100U/mL (Gla-100), observed over 6 months in insulin-naïve people with type 2 diabetes, are maintained after 12 months.

METHODS

EDITION 3 was a phase 3a, randomized, multicentre, open-label, parallel-group, treat-to-target study of once-daily Gla-300 versus Gla-100 (target fasting self-monitored plasma glucose, 4.4-5.6mmol/L [80-100mg/dL]). Participants completing the initial 6-month treatment phase continued their previously allocated basal insulin.

RESULTS

Of 878 participants randomized, 337/439 (77%) and 314/439 (72%) assigned to Gla-300 and Gla-100, respectively, completed 12 months of treatment. Improved glycaemic control was sustained until 12 months in both treatment groups, with similar reductions in HbA from baseline to month 12 (difference: -0.08 [95% confidence interval (CI): -0.23 to 0.07] % or -0.9 [-2.5 to 0.8] mmol/mol). Relative risk of experiencing≥1 confirmed (≤3.9mmol/L [≤70mg/dL]) or severe hypoglycaemic event with Gla-300 versus Gla-100 was 0.86 (95% CI: 0.69 to 1.07) at night and 0.92 (0.82 to 1.03) at any time of day. For events with a glycaemic threshold of<3.0mmol/L (<54mg/dL) these numbers were 0.76 (0.49 to 1.19) and 0.66 (0.50 to 0.88). A similar pattern was seen for documented symptomatic events. No between-group differences in adverse events were identified.

CONCLUSION

Over 12 months, Gla-300 treatment was as effective as Gla-100 in reducing HbA in insulin-naïve people with type 2 diabetes, with lower overall risk of hypoglycaemia at the<3.0mmol/L threshold.

摘要

目的

探讨在初诊 2 型糖尿病患者中,观察到的胰岛素 glargine 300U/mL(Gla-300)与胰岛素 glargine 100U/mL(Gla-100)在 6 个月时的疗效和安全性发现是否在 12 个月后仍能维持。

方法

EDITION 3 是一项为期 3a 期、随机、多中心、开放性、平行组、以目标为导向的研究,比较了每日一次 Gla-300 与 Gla-100(目标空腹自我监测血浆葡萄糖 4.4-5.6mmol/L[80-100mg/dL])。完成初始 6 个月治疗阶段的参与者继续接受之前分配的基础胰岛素。

结果

在 878 名随机分组的参与者中,分别有 337/439(77%)和 314/439(72%)名参与者被分配到 Gla-300 和 Gla-100 组,分别有 337/439(77%)和 314/439(72%)名参与者完成了 12 个月的治疗。两组的血糖控制均持续至 12 个月,从基线到第 12 个月时 HbA 均有相似的降低(差值:-0.08[95%置信区间(CI):-0.23 至 0.07]%或-0.9[-2.5 至 0.8]mmol/mol)。Gla-300 与 Gla-100 相比,夜间发生≥1 次确认(≤3.9mmol/L[≤70mg/dL])或严重低血糖事件的相对风险为 0.86(95%CI:0.69 至 1.07),任何时间的低血糖事件风险为 0.92(0.82 至 1.03)。对于血糖阈值<3.0mmol/L(<54mg/dL)的事件,这些数字分别为 0.76(0.49 至 1.19)和 0.66(0.50 至 0.88)。有症状事件的记录也有类似的模式。未发现两组间不良事件存在差异。

结论

在 12 个月的时间里,Gla-300 治疗在降低初诊 2 型糖尿病患者的 HbA 方面与 Gla-100 一样有效,并且在<3.0mmol/L 阈值时总体低血糖风险较低。

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