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本文引用的文献

1
Combination therapy with insulin glargine plus metformin but not insulin glargine plus sulfonylurea provides similar glycemic control to triple oral combination therapy in patients with type 2 diabetes uncontrolled with dual oral agent therapy.对于使用两种口服药物治疗血糖仍未得到控制的2型糖尿病患者,甘精胰岛素联合二甲双胍治疗而非甘精胰岛素联合磺脲类药物治疗能提供与三联口服联合治疗相似的血糖控制效果。
J Diabetes Complications. 2015 Nov-Dec;29(8):1266-71. doi: 10.1016/j.jdiacomp.2015.05.022. Epub 2015 Jun 5.
2
Insulin glargine compared with premixed insulin for management of insulin-naïve type 2 diabetes patients uncontrolled on oral antidiabetic drugs: the open-label, randomized GALAPAGOS study.甘精胰岛素与预混胰岛素用于治疗口服降糖药控制不佳的初治2型糖尿病患者的疗效比较:开放标签、随机化的加拉帕戈斯研究
J Diabetes Complications. 2015 Aug;29(6):838-45. doi: 10.1016/j.jdiacomp.2015.04.003. Epub 2015 Apr 11.
3
Long-term insulin glargine therapy in type 2 diabetes mellitus: a focus on cardiovascular outcomes.2型糖尿病的长效甘精胰岛素治疗:关注心血管结局
Vasc Health Risk Manag. 2015 Jan 28;11:107-16. doi: 10.2147/VHRM.S50286. eCollection 2015.
4
Long-term glycemic control after 6 months of basal insulin therapy.基础胰岛素治疗6个月后的长期血糖控制。
Am J Manag Care. 2014 Sep 1;20(9):e369-79.
5
Initiating therapy or switching to biphasic insulin aspart improves glycaemic control in type 2 diabetes: an Indian experience from the A1chieve study.启动治疗或换用双相门冬胰岛素可改善2型糖尿病患者的血糖控制:来自A1chieve研究的印度经验。
J Assoc Physicians India. 2013 Jan;61(1 Suppl):16-20.
6
Age-specific effectiveness and safety of newly initiated insulin therapy in Japanese patients with uncontrolled diabetes.新起始胰岛素治疗在血糖控制不佳的日本患者中的年龄特异性疗效和安全性。
Diabetes Ther. 2013 Dec;4(2):473-86. doi: 10.1007/s13300-013-0049-4. Epub 2013 Dec 10.
7
Basal insulin and cardiovascular and other outcomes.基础胰岛素与心血管及其他结局
N Engl J Med. 2012 Nov 1;367(18):1761-2; author reply 1763-4. doi: 10.1056/NEJMc1210553.
8
Insulin glargine versus sitagliptin in insulin-naive patients with type 2 diabetes mellitus uncontrolled on metformin (EASIE): a multicentre, randomised open-label trial.甘精胰岛素对比西格列汀在二甲双胍控制不佳的 2 型糖尿病胰岛素初治患者中的疗效(EASIE):一项多中心、随机、开放标签试验。
Lancet. 2012 Jun 16;379(9833):2262-9. doi: 10.1016/S0140-6736(12)60439-5. Epub 2012 Jun 9.
9
Update on insulin therapy for type 2 diabetes.2 型糖尿病胰岛素治疗进展。
J Clin Endocrinol Metab. 2012 May;97(5):1405-13. doi: 10.1210/jc.2011-2202. Epub 2012 Mar 22.
10
Effects of basal insulin analog and metformin on glycaemia control and weight as risk factors for endothelial dysfunction.基础胰岛素类似物和二甲双胍对血糖控制及体重的影响作为内皮功能障碍的危险因素
Bosn J Basic Med Sci. 2008 Nov;8(4):309-12. doi: 10.17305/bjbms.2008.2882.

甘精胰岛素治疗单用或联用两种口服降糖药血糖控制不佳的2型糖尿病患者的短期疗效及安全性:一项前瞻性开放标签研究

Short Term Efficacy and Safety of Insulin Glargine in Type 2 Diabetes Inadequately Controlled with Single or Two Oral Agents: A Prospective, Open Label Study.

作者信息

Aggarwal Ajay, Wadhwa Roopak

机构信息

Senior Consultant, Department of Endocrinology, Fortis Hospital, Shalimar Bagh, New Delhi, India.

Consultant, Department of Endocrinology, Fortis Hospital, Shalimar Bagh, New Delhi, India.

出版信息

J Clin Diagn Res. 2017 Jul;11(7):OC21-OC24. doi: 10.7860/JCDR/2017/27649.10214. Epub 2017 Jul 1.

DOI:10.7860/JCDR/2017/27649.10214
PMID:28892956
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5583854/
Abstract

INTRODUCTION

Basal insulin is among the second line treatment options for Type 2 Diabetes Mellitus (T2DM). Efficacy and safety of basal insulin in patients of T2DM, uncontrolled with Oral Antidiabetic Agents (OAAs) remains understudied in the Indian setting.

AIM

To assess the efficacy and safety of insulin glargine in patients with T2DM who have uncontrolled glycaemic levels despite single or two OAAs therapy.

MATERIALS AND METHODS

In this prospective, open label study, T2DM patients above 40 years of age, having inadequate glycaemic control [Glycosylated Haemoglobin (HbA1c) above 8% and/or fasting glucose level of 140 mg/dl and above] with single or two OAAs over three consecutive months were included. Dosing of insulin glargine was adjusted as per Fasting Blood Glucose (FBG) and Post Prandial Blood Glucose (PPBG) levels. Patients were followed for 12 weeks and data was analysed by comparing 12 week findings to baseline values.

RESULTS

In 40 cases included in final analysis, mean age was 56.35 ± 6.77 years, 52.5% were females and mean body mass index was 26.96 ± 4.59 kg/m. Compared to baseline, significant reduction in HbA1c, FBG and PPBG blood glucose (all p<0.05) was seen. HbA1c goal of < 7% was achieved in 37.5% cases. Systolic (p>0.05) and diastolic (p<0.05) blood pressures reduced at 12 weeks as compared to baseline. Increase in weight was modest with mean increase of 1.06 kg (p>0.05). Overall, 14 symptomatic hypoglycaemia events were observed with none being severe.

CONCLUSION

Short term administration of insulin glargine is effective in reducing glycaemia and is safe with lower rates of severe hypoglycaemia. It can be considered in patients with uncontrolled T2DM on mono- or two- OAAs treatment.

摘要

引言

基础胰岛素是2型糖尿病(T2DM)二线治疗方案之一。在印度,对于口服抗糖尿病药物(OAA)治疗效果不佳的T2DM患者,基础胰岛素的疗效和安全性仍未得到充分研究。

目的

评估甘精胰岛素对单药或两药治疗后血糖仍未得到有效控制的T2DM患者的疗效和安全性。

材料与方法

本前瞻性、开放标签研究纳入了年龄在40岁以上、连续三个月单药或联合两药OAA治疗后血糖控制不佳(糖化血红蛋白(HbA1c)高于8%和/或空腹血糖水平在140mg/dl及以上)的T2DM患者。根据空腹血糖(FBG)和餐后血糖(PPBG)水平调整甘精胰岛素剂量。对患者进行12周的随访,并通过比较12周的结果与基线值来分析数据。

结果

最终分析纳入的40例患者中,平均年龄为56.35±6.77岁,52.5%为女性,平均体重指数为26.96±4.59kg/m²。与基线相比,HbA1c、FBG和PPBG均显著降低(p均<0.05)。37.5%的患者HbA1c目标达到<7%。与基线相比,12周时收缩压(p>0.05)和舒张压(p<0.05)降低。体重平均增加1.06kg,增加幅度较小(p>0.05)。总体而言,共观察到14次有症状的低血糖事件,均不严重。

结论

短期使用甘精胰岛素可有效降低血糖,安全性良好,严重低血糖发生率较低。对于单药或两药OAA治疗后血糖控制不佳的T2DM患者,可考虑使用甘精胰岛素。