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基础胰岛素类似物治疗对既往胰岛素治疗控制不佳的2型糖尿病患者的临床益处:一项前瞻性、非干预性、多中心研究。

Clinical Benefit of Basal Insulin Analogue Treatment in Persons with Type 2 Diabetes Inadequately Controlled on Prior Insulin Therapy: A Prospective, Noninterventional, Multicenter Study.

作者信息

Bjekić-Macut Jelica, Živković Teodora Beljić, Kocić Radivoj

机构信息

Belgrade School of Medicine, Bezanijska Kosa University Medical Center, Division of Endocrinology, Diabetes and Metabolic disorders, University of Belgrade, Belgrade, Serbia.

Belgrade School of Medicine, "Zvezdara" University Medical Center, Division of Endocrinology, Diabetes and Metabolic disorders, University of Belgrade, Belgrade, Serbia.

出版信息

Diabetes Ther. 2018 Apr;9(2):651-662. doi: 10.1007/s13300-018-0378-4. Epub 2018 Feb 19.

Abstract

INTRODUCTION

Basal insulin analogues offer persons with type 2 diabetes mellitus (T2DM) adequate glycemic control combined with a favorable safety profile. BASAL-BALI-a prospective, noninterventional, multicenter disease registry-assessed the effectiveness and safety of basal insulin analogues in adult Serbians with T2DM previously inadequately controlled on other insulin types.

METHODS

The primary objective was to assess the reduction in glycated hemoglobin (HbA) from basal insulin analogue initiation to the end of a 6-month observation period. Data collection was performed at three study visits: baseline, 3 months, and 6 months. All treatments and procedures were performed at the physicians' discretion.

RESULTS

In total, 460 subjects were included. Mean diabetes duration was 11.6 ± 6.6 years. Late complications of diabetes were present in 67% of subjects and comorbidities in 85%. After 6 months, the mean reduction in HbA was 1.8% (p < 0.01 vs. baseline); body weight (mean reduction of 0.9 kg, p < 0.01), waist circumference (1.5 cm, p < 0.01), and BMI (0.2 kg/m, p < 0.01) were also reduced. A total of 49.1% of subjects reached their individualized HbA treatment target, and 42.0% met the composite HbA and fasting plasma glucose (FPG) target. The incidence of symptomatic hypoglycemia was reduced from 96.3% in the 6 months prior to initiating basal insulin analogues to 15.4% over the 6-month treatment period.

CONCLUSION

Introducing basal insulin analogues in persons with T2DM previously inadequately controlled on other insulin types can significantly improve glycemic control and reduce the risk of hypoglycemia, without adversely affecting body weight.

FUNDING

Sanofi, Serbia.

摘要

引言

基础胰岛素类似物可为2型糖尿病(T2DM)患者提供充分的血糖控制,并具有良好的安全性。BASAL-BALI研究——一项前瞻性、非干预性、多中心疾病登记研究——评估了基础胰岛素类似物在之前使用其他类型胰岛素血糖控制不佳的成年塞尔维亚T2DM患者中的有效性和安全性。

方法

主要目标是评估从开始使用基础胰岛素类似物到6个月观察期结束时糖化血红蛋白(HbA)的降低情况。在三次研究访视时进行数据收集:基线、3个月和6个月。所有治疗和程序均由医生自行决定。

结果

共纳入460名受试者。平均糖尿病病程为11.6±6.6年。67%的受试者存在糖尿病晚期并发症,85%的受试者存在合并症。6个月后,HbA平均降低1.8%(与基线相比,p<0.01);体重(平均降低0.9kg,p<0.01)、腰围(1.5cm,p<0.01)和体重指数(0.2kg/m²,p<0.01)也有所降低。共有49.1%的受试者达到了个体化的HbA治疗目标,42.0%的受试者达到了HbA和空腹血糖(FPG)综合目标。有症状低血糖的发生率从开始使用基础胰岛素类似物前6个月的96.3%降至6个月治疗期的15.4%。

结论

在之前使用其他类型胰岛素血糖控制不佳的T2DM患者中引入基础胰岛素类似物可显著改善血糖控制并降低低血糖风险,且对体重无不利影响。

资助

赛诺菲,塞尔维亚。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02ac/6104277/9c48165129a0/13300_2018_378_Fig1_HTML.jpg

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