胰岛素甘精在巴西 1 型糖尿病患者中的临床疗效：研究结果与启示。

The clinical effectiveness of insulin glargine in patients with Type I diabetes in Brazil: findings and implications.

作者信息

Marra Lays P, Araújo Vânia E, Oliveira Gerusa Cc, Diniz Leonardo M, Guerra Júnior Augusto A, Acurcio Francisco de Assis, Godman Brian, Álvares Juliana

机构信息

Department of Social Pharmacy, School of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil.

School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.

出版信息

J Comp Eff Res. 2017 Sep;6(6):519-527. doi: 10.2217/cer-2016-0099. Epub 2017 Sep 29.

DOI:10.2217/cer-2016-0099

PMID:28960085

Abstract

AIM

Published studies have challenged the cost-effectiveness of insulin glargine versus neutral protamine hagedorn (NPH) insulins in Brazil with limited evidence of increased effectiveness despite considerably higher acquisition costs. However, still a controversy. Consequently, there is a need to address this.

MATERIALS & METHODS: Retrospective cohort study of Type I diabetes patients receiving insulin glargine in Brazil following NPH insulin who met the criteria.

RESULTS

580 patients were enrolled. HbA varied from 8.80 ± 1.98% in NPH insulin users to 8.54 ± 1.88% after insulin glargine for 6 months, which is not clinically significant. Frequency of glycemic control varied from 22.6% with NPH insulin to 26.2% with insulin glargine. No statistically significant difference was observed between controlled and still uncontrolled groups for all analyzed factors including type and frequency of insulin use and carbohydrate counting.

CONCLUSION

Limited differences between NPH insulins and insulin analogs in routine clinical care do not justify an appreciable cost difference.

摘要

目的

已发表的研究对巴西甘精胰岛素与中性鱼精蛋白锌胰岛素（NPH）相比的成本效益提出了质疑，尽管获取成本高得多，但有效性增加的证据有限。然而，这仍然存在争议。因此，有必要解决这个问题。

材料与方法

对巴西符合标准的在使用NPH胰岛素后改用甘精胰岛素的I型糖尿病患者进行回顾性队列研究。

结果

共纳入580例患者。使用NPH胰岛素的患者糖化血红蛋白（HbA）为8.80±1.98%，使用甘精胰岛素6个月后为8.54±1.88%，这在临床上无显著意义。血糖控制频率从使用NPH胰岛素的22.6%变化为使用甘精胰岛素的26.2%。在所有分析因素（包括胰岛素使用类型和频率以及碳水化合物计数）方面，在血糖控制组和未控制组之间未观察到统计学上的显著差异。