Pearson Scott M, Trujillo Jennifer M
University of Colorado Skaggs, School of Pharmacy and Pharmaceutical Sciences, 12850 East Montview Boulevard, Mail Stop C238. Aurora, CO 80045, USA University of Colorado, 12850 East Montview Boulevard, CO 80045, USA.
University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado.
Ther Adv Endocrinol Metab. 2018 Apr;9(4):113-121. doi: 10.1177/2042018818760962. Epub 2018 Mar 22.
We wanted to determine whether basal insulin requirements change when patients transition from insulin glargine U-100 (Gla-100) to insulin glargine U-300 (Gla-300) or insulin degludec.
This study involved subjects seen in the University of Colorado Health Endocrine Clinic who were transitioned from Gla-100 to either Gla-300 ( = 95) or insulin degludec ( = 39). The primary outcome was the difference between baseline Gla-100 dose and dose of Gla-300 or insulin degludec prescribed after first follow-up visit within 1-12 months. Secondary outcomes included changes in glycemic control and empiric dose conversion from Gla-100 to Gla-300 or insulin degludec on the day of transition. Wilcoxon rank sum tests evaluated changes in insulin doses, and paired tests assessed changes in glycemic control using GraphPad statistical software.
Median daily basal insulin dose increased for individuals transitioned from Gla-100 to Gla-300 from 30 [19-60 interquartile range (IQR)] units at baseline to 34.5 (19-70 IQR) units after follow up ( = 0.01). For patients transitioned to insulin degludec, dose changes from baseline to follow up were not significantly different ( = 0.56). At the time of transition, the prescribed dose of Gla-300 or insulin degludec did not significantly differ from the previous dose of Gla-100 ( = 0.73 and 0.28, respectively), indicating that empiric dose adjustments were not routinely prescribed.
Patients who transitioned from Gla-100 to Gla-300 had increased basal insulin requirements between visits, while basal insulin requirements for those transitioned from Gla-100 to insulin degludec were not significantly different.
我们想要确定患者从甘精胰岛素U-100（Gla-100）转换为甘精胰岛素U-300（Gla-300）或德谷胰岛素时，基础胰岛素需求量是否会发生变化。
本研究纳入了在科罗拉多大学健康内分泌诊所就诊的受试者，这些受试者从Gla-100转换为Gla-300（n = 95）或德谷胰岛素（n = 39）。主要结局是基线Gla-100剂量与1至12个月内首次随访后开具的Gla-300或德谷胰岛素剂量之间的差异。次要结局包括血糖控制的变化以及转换当天从Gla-100到Gla-300或德谷胰岛素的经验性剂量转换。采用Wilcoxon秩和检验评估胰岛素剂量的变化，并使用GraphPad统计软件通过配对t检验评估血糖控制的变化。
从Gla-100转换为Gla-300的个体，每日基础胰岛素剂量中位数从基线时的30[四分位间距（IQR）为19 - 60]单位增加到随访后的34.5（IQR为19 - 70）单位（P = 0.01）。对于转换为德谷胰岛素的患者，从基线到随访的剂量变化无显著差异（P = 0.56）。在转换时，Gla-300或德谷胰岛素的开具剂量与先前的Gla-100剂量无显著差异（分别为P = 0.73和0.28），这表明未常规进行经验性剂量调整。
从Gla-100转换为Gla-300的患者在就诊期间基础胰岛素需求量增加，而从Gla-100转换为德谷胰岛素的患者基础胰岛素需求量无显著差异。
