Kawaguchi Yuji, Sawa Jun, Hamai Chie, Kumeda Yasuro
Department of Internal Medicine, Minamiosaka Hospital, Osaka, Japan.
Diabetes Ther. 2019 Aug;10(4):1535-1541. doi: 10.1007/s13300-019-0654-y. Epub 2019 Jun 21.
Hypoglycemia resulting from insulin therapy for treatment of diabetes increases the risk of adverse cardiovascular events. Determining biomarkers that provide accurate estimation of hypoglycemia risk may allow for more accurate patient management and care. The purpose of this study was to determine the cutoff value of serum albumin (s-alb) that increases the risk of hypoglycemia in patients treated with insulin degludec.
This study used a crossover design and randomized 30 patients admitted for glycemic control to compare differences between insulin glargine 300 U/ml (Gla300) and degludec treatments.
The cutoff value of s-alb associated with 24-h hypoglycemia and nocturnal hypoglycemia in patients treated with degludec was 3.8 g/dl. In patients with s-alb levels < 3.8 g/dl, mean percentages of time with hypoglycemia, clinically important hypoglycemia, and nocturnal hypoglycemia were significantly lower in those treated with Gla300 compared with patients treated with degludec.
This study identified a cutoff value for s-alb levels that indicates risk of hypoglycemia in patients treated with degludec. Monitoring s-alb levels in patients treated with degludec will help to mitigate the risk of hypoglycemia.
University Hospital Medical Information Network (UMIN 000031044).
胰岛素治疗糖尿病导致的低血糖会增加不良心血管事件的风险。确定能够准确评估低血糖风险的生物标志物，可能有助于更精确地管理和护理患者。本研究的目的是确定在接受德谷胰岛素治疗的患者中，增加低血糖风险的血清白蛋白（s-alb）临界值。
本研究采用交叉设计，将30名因血糖控制入院的患者随机分组，比较300 U/ml甘精胰岛素（Gla300）和德谷胰岛素治疗之间的差异。
接受德谷胰岛素治疗的患者中，与24小时低血糖和夜间低血糖相关的s-alb临界值为3.8 g/dl。在s-alb水平<3.8 g/dl的患者中，与接受德谷胰岛素治疗的患者相比，接受Gla300治疗的患者低血糖、具有临床意义的低血糖和夜间低血糖的平均时间百分比显著更低。
本研究确定了s-alb水平的临界值，该临界值表明接受德谷胰岛素治疗的患者存在低血糖风险。监测接受德谷胰岛素治疗患者的s-alb水平将有助于降低低血糖风险。
大学医院医学信息网络（UMIN 000031044）。
