a Eli Lilly SA , Dubai , United Arab Emirates.
b Hospital Universiti Sains Malaysia , Kelantan , Malaysia.
Curr Med Res Opin. 2018 Sep;34(9):1653-1662. doi: 10.1080/03007995.2018.1484712. Epub 2018 Jun 14.
Current and future estimates of the burden of diabetes for the Western Pacific (WP) region are among the highest in the world. Verifying Insulin Strategy and Initial Health Outcome Analysis (VISION) was an 18 month observational study that explored treatment approaches in patients with type 2 diabetes mellitus (T2DM) initiating insulin in the WP region.
A total of 1065 patients aged ≥18 years with T2DM initiating insulin therapy in normal clinical course were enrolled from Hong Kong, Malaysia, Philippines, Taiwan and Thailand. Participants' data was recorded by the treating physicians. Patient-reported outcomes (PROs) were assessed using questionnaires completed by participants.
The mean age of patients was 57.2 years with mean glycosylated hemoglobin (HbA1c) of 10.0%. About 66% of patients had an HbA1c ≥9.0% at insulin initiation despite 74% of them being on two or more oral antidiabetic agents at the time of insulin initiation. Basal insulin was initiated in 72% and premixed insulin in 27% of patients. Changes in insulin therapy was observed in 63% of patients and, by the end of study, 28% achieved HbA1c levels of <7.5%. The proportion of patients completely satisfied with their insulin treatment increased over the study course and the quality of life (QoL) score increased from baseline to the study end.
As high HbA1C levels indicate a delayed start of insulin therapy, timely initiation and early intensification of insulin therapy is necessary in the region to achieve adequate glycemic control in time and prevent diabetes complications. Data from PROs suggests that the insulin treatment improves QoL in most patients.
目前和未来对西太平洋（WP）地区糖尿病负担的估计是世界上最高的之一。验证胰岛素策略和初始健康结果分析（VISION）是一项为期 18 个月的观察性研究，旨在探索 WP 地区开始使用胰岛素治疗 2 型糖尿病（T2DM）患者的治疗方法。
共纳入 1065 名年龄≥18 岁、在正常临床过程中开始胰岛素治疗的 T2DM 患者，来自中国香港、马来西亚、菲律宾、中国台湾和泰国。由主治医生记录患者数据。使用由参与者完成的问卷评估患者报告的结果（PRO）。
患者的平均年龄为 57.2 岁，平均糖化血红蛋白（HbA1c）为 10.0%。尽管 74%的患者在开始使用胰岛素时已经服用了两种或更多种口服抗糖尿病药物，但仍有 66%的患者在开始胰岛素治疗时 HbA1c≥9.0%。72%的患者开始使用基础胰岛素，27%的患者开始使用预混胰岛素。63%的患者观察到胰岛素治疗的变化，在研究结束时，28%的患者达到 HbA1c<7.5%的水平。在研究过程中，完全满意胰岛素治疗的患者比例增加，生活质量（QoL）评分从基线升高到研究结束。
由于高 HbA1c 水平表明胰岛素治疗开始延迟，因此有必要在该地区及时启动和早期强化胰岛素治疗，以及时控制血糖并预防糖尿病并发症。PROs 的数据表明，胰岛素治疗改善了大多数患者的 QoL。
