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在中东和北非地区,2 型糖尿病患者胰岛素起始和强化的模式和趋势。

Patterns and trends in insulin initiation and intensification among patients with Type 2 diabetes mellitus in the Middle East and North Africa region.

机构信息

Diabetes and Endocrine Unit, Department of Endocrinology, Medcare Hospital, Jumeira, Dubai, United Arab Emirates.

Diabetes and Metabolism Unit, Department of Internal Medicine, Alexandria University, Alexandria, Egypt.

出版信息

Diabetes Res Clin Pract. 2019 Mar;149:18-26. doi: 10.1016/j.diabres.2019.01.017. Epub 2019 Jan 14.

Abstract

AIM

Current and future estimates of the burden of diabetes in the Middle East and North Africa (MENA) region are among the highest in the world. VISION, an 18-month observational study, explored patterns of insulin initiation and intensification in T2DM patients in the MENA region.

METHODS

1192 patients aged ≥18 years were enrolled from Algeria, Egypt, Saudi Arabia and the UAE. Treating physicians recorded participants' data. Patient-reported outcomes (PROs) were assessed using questionnaires completed by participants.

RESULTS

67.6% patients had HbA1c ≥9% at insulin initiation, with a mean HbA1c of 9.9%, despite 68.3% patients being on ≥2 oral anti-diabetics, indicating a significant delay in insulin initiation. Basal insulin was initiated in 50.6% and premixed insulin in 46.3% patients. After 18 months, changes in insulin therapy were observed in 33.7% patients, while 39.6% patients achieved HbA1c levels of <7.5%. The proportion of patients completely satisfied with their insulin treatment, and the QoL increased over the study course.

CONCLUSION

Results support that timely initiation and early intensification of insulin therapy are necessary in the region to achieve adequate and timely glycemic control and to prevent diabetic complications.

摘要

目的

目前和未来对中东和北非(MENA)地区糖尿病负担的估计是世界上最高的之一。VISION 是一项为期 18 个月的观察性研究,旨在探讨 MENA 地区 2 型糖尿病患者起始和强化胰岛素治疗的模式。

方法

从阿尔及利亚、埃及、沙特阿拉伯和阿联酋招募了 1192 名年龄≥18 岁的患者。治疗医生记录了参与者的数据。使用参与者完成的问卷评估患者报告的结局(PROs)。

结果

67.6%的患者在起始胰岛素时 HbA1c≥9%,平均 HbA1c 为 9.9%,尽管 68.3%的患者正在服用≥2 种口服抗糖尿病药物,这表明胰岛素起始存在显著延迟。50.6%的患者起始基础胰岛素,46.3%的患者起始预混胰岛素。18 个月后,33.7%的患者胰岛素治疗发生变化,而 39.6%的患者 HbA1c 水平<7.5%。在研究过程中,患者对胰岛素治疗的完全满意度和生活质量有所提高。

结论

研究结果表明,在该地区需要及时起始和早期强化胰岛素治疗,以实现充分和及时的血糖控制,并预防糖尿病并发症。

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