Department of Medicine, Division of Endocrinology and Metabolism, Jichi Medical University Saitama Medical Center, Saitama, Japan.
J Diabetes Investig. 2020 Sep;11(5):1230-1237. doi: 10.1111/jdi.13240. Epub 2020 Mar 27.
AIMS/INTRODUCTION: Studies have shown that sodium-glucose cotransporter 2 (SGLT2) inhibitors increased time-in-range (TIR; percentage of time glucose level remains between 3.9 and 10.0 mmol/L [70-180 mg/dL]) and decreased glycemic variability in patients with type 1 diabetes. The aim of this study was to investigate the effects of SGLT2 inhibitors on TIR, glycemic variability and glucose control in Japanese patients with type 1 diabetes in a real clinical setting.
We designed a single-arm, retrospective cohort study to analyze data from patients starting to use ipragliflozin or dapagliflozin and who used a sensor-based flash glucose monitoring system between February 2019 and August 2019. We measured TIR, time above range >180 mg/dL (percentage of time with glucose level of >180 mg/dL or >10.0 mmol/L), time below range <70 mg/dL (percentage of time with glucose level of <70 mg/dL or <3.9 mmol/L), mean glucose and standard deviation, and coefficient of variation for glycemic variability, and then compared the data before and after SGLT2 inhibitors treatments.
We enrolled 15 patients in the study. The total dosages of basal insulin decreased significantly, but the total doses of bolus insulin did not change significantly. TIR increased significantly by approximately 11.6%; the time below range <70 mg/dL remained unchanged; and the mean glucose and standard deviation decreased significantly, whereas the coefficients of variation did not.
SGLT2 inhibitors improved TIR and the mean glucose level and standard deviation without increasing the time below range <70 mg/dL in patients with type 1 diabetes.
目的/引言:研究表明,钠-葡萄糖共转运蛋白 2(SGLT2)抑制剂可增加时间在范围内(TIR;血糖水平在 3.9 至 10.0mmol/L[70-180mg/dL]之间的时间百分比)并降低 1 型糖尿病患者的血糖变异性。本研究旨在探讨 SGLT2 抑制剂在真实临床环境中对日本 1 型糖尿病患者 TIR、血糖变异性和血糖控制的影响。
我们设计了一项单臂、回顾性队列研究,以分析 2019 年 2 月至 2019 年 8 月期间开始使用伊格列净或达格列净且使用基于传感器的即时血糖监测系统的患者的数据。我们测量了 TIR、血糖水平 >180mg/dL(血糖水平 >180mg/dL 或 >10.0mmol/L 的时间百分比)、血糖水平 <70mg/dL(血糖水平 <70mg/dL 或 <3.9mmol/L 的时间百分比)、平均血糖和标准差以及血糖变异性的变异系数,然后比较 SGLT2 抑制剂治疗前后的数据。
我们纳入了 15 名患者进行研究。基础胰岛素的总剂量显著降低,但速效胰岛素的总剂量无明显变化。TIR 显著增加了约 11.6%;血糖水平 <70mg/dL 的时间保持不变;平均血糖和标准差显著降低,而变异系数则没有。
SGLT2 抑制剂改善了 1 型糖尿病患者的 TIR 和平均血糖水平及标准差,而不增加血糖水平 <70mg/dL 的时间。