Lyu Fu-Ping, Huang Bing-Kun, Su Wei-Juan, Yan Fang-Fang, Zeng Jin-Yang, Chen Zheng, Zhang Yu-Xian, Wang Shun-Hua, Huang Yin-Xiang, Zhang Mu-Lin, Shi Xiu-Lin, Lin Ming-Zhu, Li Xue-Jun
Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, Xiamen, China.
Xiamen Diabetes Institute, The First Affiliated Hospital of Xiamen University, Xiamen, China.
Diabetes Ther. 2020 Mar;11(3):701-710. doi: 10.1007/s13300-020-00758-5. Epub 2020 Feb 4.
The aim of this study was to compare the efficacy of vildagliptin as add-on therapy to short-term continuous subcutaneous insulin infusion (CSII) with CSII monotherapy in hospitalized patients with type 2 diabetes mellitus (T2DM).
A total of 200 hospitalized patients with inadequately controlled T2DM were randomized into groups, with one group receiving CSII monotherapy (CSII group, n =100) and the other group receiving CSII plus vildagliptin as add-on (CSII + Vig group, n = 100). Of these, 191 completed the 7-day trial (CSII group, n = 99; CSII + Vig group, n = 92) and included in the analysis. The glycemic control and variability of the patients were measured using all-day capillary blood glucose (BG) monitoring. Weight and fasting C-peptide levels were evaluated before and after the interventions.
Mean BG concentrations during the whole treatment period were lower and the time to reach target BG was reduced in the CSII + Vig group compared with the CSII group (9.89 ± 3.37 vs. 9.46 ± 3.23 mmol/L, P < 0.01; 129 ± 4 vs. 94 ± 5 h, P < 0.01, respectively). Similarly, the indicators of glycemic variability, namely the standard deviation of BG and the largest amplitude of glycemic excursion, were significantly decreased in the CSII + Vig group compared with the CSII group (2.68 ± 1.05 vs. 2.39 ± 1.00 mmol/L, P < 0.01; 7.19 ± 2.86 vs. 6.23 ± 2.73 mmol/L, P < 0.01, respectively).
Short-term CSII with vildagliptin as add-on therapy may be an optimized treatment for hospitalized patients with T2DM compared with short-term CSII monotherapy.
本研究旨在比较维格列汀作为短期持续皮下胰岛素输注（CSII）的附加治疗与CSII单一疗法对住院2型糖尿病（T2DM）患者的疗效。
总共200例住院的T2DM控制不佳患者被随机分组，一组接受CSII单一疗法（CSII组，n = 100），另一组接受CSII加维格列汀作为附加治疗（CSII + 维格列汀组，n = 100）。其中，191例完成了为期7天的试验（CSII组，n = 99；CSII + 维格列汀组，n = 92）并纳入分析。通过全天毛细血管血糖（BG）监测来测量患者的血糖控制和变异性。在干预前后评估体重和空腹C肽水平。
与CSII组相比，CSII + 维格列汀组在整个治疗期间的平均BG浓度更低，达到目标BG的时间更短（分别为9.89 ± 3.37 vs. 9.46 ± 3.23 mmol/L，P < 0.01；129 ± 4 vs. 94 ± 5小时，P < 0.01）。同样，与CSII组相比，CSII + 维格列汀组的血糖变异性指标，即BG标准差和血糖波动最大幅度，显著降低（分别为2.68 ± 1.05 vs. 2.39 ± 1.00 mmol/L，P < 0.01；7.19 ± 2.86 vs. 6.23 ± 2.73 mmol/L，P < 0.01）。
与短期CSII单一疗法相比，短期CSII联合维格列汀作为附加治疗可能是住院T2DM患者的优化治疗方案。
