Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210029, China.
Division of Endocrinology, Department of Medicine, National University of Singapore, Singapore, Singapore.
J Endocrinol Invest. 2018 Feb;41(2):179-184. doi: 10.1007/s40618-017-0712-0. Epub 2017 Jun 22.
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).
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.
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.
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.
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。
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)。
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%。
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。