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采用连续血糖监测系统比较贝塔林和来得时治疗 2 型糖尿病患者的临床疗效和经济价值。

A comparison of clinical efficacy and economic value in Basalin- and Lantus-treated patients with type 2 diabetes using continuous glucose monitoring system.

机构信息

Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210029, China.

Division of Endocrinology, Department of Medicine, National University of Singapore, Singapore, Singapore.

出版信息

J Endocrinol Invest. 2018 Feb;41(2):179-184. doi: 10.1007/s40618-017-0712-0. Epub 2017 Jun 22.

DOI:10.1007/s40618-017-0712-0
PMID:28643298
Abstract

AIM

To determine the clinical non-inferiority of recombinant glargine-Basalin vs glargine-Lantus, in treatment of type 2 diabetes mellitus (T2DM) using continuous glucose monitoring system (CGMS).

METHODS

One hundred patients with T2DM were recruited. They were either regularly taking Basalin (Basalin group) or Lantus (Lantus group) (n = 50 each). CGMS was employed to real-time monitor blood glucose profile for 4 days (from day 1 to day 5). To exclude the effect of patient background, the study design was to have a blinded crossover from glargine-Basalin to glargine-Lantus on day 3, and vice versa. 24-hour mean blood glucose (24hMBG), 24-hour standard deviation of blood glucose (24hSDBG), 24-hour mean amplitude of glycemic excursion (24hMAGE), and number of glycemic excursion (NGE) every 24 h (24hNGE) were calculated for each glargine from 100 patients.

RESULTS

No significant difference of 24hMBG, 24hSDBG, 24hMAGE, and 24hNGE (p > 0.05 for all) was found between Basalin and Lantus treatments. The glucose area under the curve and time when blood glucose was below 3.9 mmol/L, between 3.9 and 10.0 mmol/L, or above 10.0 mmol/L were similar between Basalin and Lantus treatment. The frequency of hypoglycemic episodes was also similar. However, the mean cost of Basalin was only 72% of Lantus's in one treatment course.

CONCLUSION

Glargine-Basalin is non-inferior in clinical efficacy compared to glargine-Lantus. In view of the large difference in the cost of glargine-Basalin, it would be much more cost-effective for our patients.

摘要

目的

使用连续血糖监测系统(CGMS)评估重组甘精胰岛素-贝塔林与甘精胰岛素-来得时在治疗 2 型糖尿病(T2DM)中的临床非劣效性。

方法

本研究纳入 100 例 T2DM 患者,分为贝塔林组(n=50)和来得时组(n=50),分别使用甘精胰岛素-贝塔林和甘精胰岛素-来得时治疗。CGMS 连续 4 天(第 1-5 天)实时监测血糖谱。为排除患者背景的影响,研究设计为第 3 天两组交叉使用甘精胰岛素-贝塔林和甘精胰岛素-来得时,第 8 天反之。计算每位患者两种甘精胰岛素的 24 小时平均血糖(24hMBG)、24 小时血糖标准差(24hSDBG)、24 小时血糖波动幅度(24hMAGE)和每 24 小时血糖波动次数(24hNGE)。

结果

贝塔林组和来得时组的 24hMBG、24hSDBG、24hMAGE 和 24hNGE 无显著差异(所有 p>0.05)。贝塔林组和来得时组的血糖曲线下面积以及血糖<3.9mmol/L、3.9-10.0mmol/L 和>10.0mmol/L 的时间均相似。低血糖事件的发生频率也相似。然而,一个疗程中贝塔林的平均费用仅为来得时的 72%。

结论

与甘精胰岛素-来得时相比,甘精胰岛素-贝塔林在临床疗效方面无差异。鉴于甘精胰岛素-贝塔林的成本差异较大,对我们的患者来说,它具有更高的成本效益。

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