Petrovski Goran, Gjergji Dashamir, Grbic Aleksandra, Vukovic Blazenko, Krajnc Mitja, Grulovic Natasa
Diabetes and Metabolic Disorders, University Clinic of Endocrinology, Vodnjanska 17, 1000, Skopje, Macedonia.
Polyclinic of Specialities Nr 3, Tirana, Albania.
Diabetes Ther. 2018 Aug;9(4):1657-1668. doi: 10.1007/s13300-018-0467-4. Epub 2018 Jul 3.
Long-acting insulin analogs such as insulin glargine may offer improved glycemic control in patients with type 2 diabetes (T2D) compared to conventional insulin therapies. The objective of this study was to determine whether switching to insulin glargine had beneficial effects on glycemic control, weight gain, and incidence of hypoglycemia in patients with suboptimally managed T2D.
This prospective observational study was performed on 1041 patients who were suboptimally controlled on pre-mixed insulin therapy and were switched to an insulin glargine regimen. Clinical markers of glycemic control including glycosylated hemoglobin (HbA1c) < 7% (< 53 mmol/mol) and fasting blood glucose (FBG) levels ranging from 3.9 to 7.2 mmol/L were used for the primary outcome measures. Follow-up assessment of primary outcomes, weight gain, incidence of hypoglycemia, and patient satisfaction with the therapy was performed after three and six months of treatment.
Target therapeutic values of HbA1c were achieved in 9.3% and 30.2% of patients, whereas FBG target values were achieved in 25.9% and 52.3% of patients after the third and sixth month of therapy, respectively. Both the HbA1c and FBG targets were reached in 7% and 25.9% of patients at the third and sixth month of therapy, respectively. Switching to insulin glargine decreased the incidence of hypoglycemia from 49.5% to 5.2% after six months of therapy; this decrease was associated with weight loss and was well perceived by the patients.
Insulin glargine-based regimens are beneficial and safe therapeutic alternatives for T2D patients inadequately controlled with pre-mixed insulin.
Sanofi-Aventis Croatia d.o.o., Zagreb, Croatia.
与传统胰岛素疗法相比，甘精胰岛素等长效胰岛素类似物可能会改善2型糖尿病（T2D）患者的血糖控制。本研究的目的是确定改用甘精胰岛素对血糖控制不佳的T2D患者的血糖控制、体重增加和低血糖发生率是否有有益影响。
本前瞻性观察性研究对1041例预混胰岛素治疗血糖控制不佳且改用甘精胰岛素治疗方案的患者进行。血糖控制的临床指标包括糖化血红蛋白（HbA1c）<7%（<53 mmol/mol）和空腹血糖（FBG）水平在3.9至7.2 mmol/L之间，作为主要结局指标。在治疗3个月和6个月后，对主要结局、体重增加、低血糖发生率以及患者对治疗的满意度进行随访评估。
治疗3个月和6个月后，分别有9.3%和30.2%的患者达到HbA1c目标治疗值，而分别有25.9%和52.3%的患者达到FBG目标值。治疗3个月和6个月时，分别有7%和25.9%的患者同时达到HbA1c和FBG目标。改用甘精胰岛素治疗6个月后，低血糖发生率从49.5%降至5.2%；这种降低与体重减轻有关，且患者对此接受度良好。
对于预混胰岛素控制不佳的T2D患者，基于甘精胰岛素的治疗方案是有益且安全的治疗选择。
赛诺菲-安万特克罗地亚有限公司，萨格勒布，克罗地亚
