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基础胰岛素治疗在罗马尼亚2型糖尿病患者现实生活环境中的疗效与安全性:DUNE研究的亚组分析

EFFICACY AND SAFETY OF BASAL INSULIN THERAPY IN ROMANIAN PATIENTS WITH TYPE 2 DIABETES IN REAL-LIFE SETTINGS: A SUB-GROUP ANALYSIS OF DUNE STUDY.

作者信息

Cerghizan A, Amorin P, Catrinoiu D, Creteanu G, Adamescu E, Moise M

机构信息

Emergency Clinical County Hospital Cluj - Clinical Center of Diabetes, Cluj-Napoca, Bucharest, Romania.

University of Oradea, Faculty of Medicine and Pharmacy, Emergency Clinical County Hospital Oradea, Oradea, Bucharest, Romania.

出版信息

Acta Endocrinol (Buchar). 2020 Jan-Mar;16(1):43-48. doi: 10.4183/aeb.2019.43.

Abstract

CONTEXT

Despite the available evidence showing the vital role of glycemic control in the management of type 2 diabetes, a significant proportion of patients are not achieving a good glycemic control.

OBJECTIVE

Here we present the results of the Diabetes Unmet Need with basal insulin Evaluation (DUNE) study for patients enrolled in Romanian centers with the aim to describe the proportion of participants who achieved individualized HbA1c targets at 12 weeks following basal insulin therapy initiation.

DESIGN

Prospective, observational study.

SUBJECTS AND METHODS

355 consecutive adults with type 2 diabetes, who were newly initiated with basal insulin therapy (Newly initiated group) or had been treated for less than 12 months with basal insulin prior to study enrollment (Previously initiated group) were enrolled and followed for 12 weeks.

RESULTS

The individualized HbA1c target was achieved by 22.7% of the patients in the Newly initiated group and by 25.0% of the patients in the Previously initiated group. During the study period, in the Newly initiated group mean basal insulin dose increased from 16.2 U at baseline to 27.6 U at 12 weeks. In the Previously initiated group, the insulin dose increased from 27.4 U at baseline to 33.1 U at 12 weeks. In both groups, 9.7% and 12.8% of the patients reported at least 1 episode of symptomatic hypoglycemia.

CONCLUSIONS

In real-world settings, despite insulin initiation a large number of patients fail to achieve their individualized glycemic targets. One of the reasons appeared to be linked to the insufficient basal insulin titration.

摘要

背景

尽管现有证据表明血糖控制在2型糖尿病管理中起着至关重要的作用,但仍有相当一部分患者未能实现良好的血糖控制。

目的

在此,我们展示了罗马尼亚各中心招募的患者的基础胰岛素未满足需求评估(DUNE)研究结果,旨在描述基础胰岛素治疗开始后12周达到个体化糖化血红蛋白(HbA1c)目标的参与者比例。

设计

前瞻性观察性研究。

对象与方法

连续纳入355例2型糖尿病成年患者,这些患者要么是新开始基础胰岛素治疗(新开始组),要么在研究入组前已接受基础胰岛素治疗少于12个月(之前已开始组),并随访12周。

结果

新开始组中22.7%的患者以及之前已开始组中25.0%的患者达到了个体化HbA1c目标。在研究期间,新开始组的基础胰岛素平均剂量从基线时的16.2单位增加到12周时的27.6单位。在之前已开始组中,胰岛素剂量从基线时的27.4单位增加到12周时的33.1单位。在两组中,分别有9.7%和12.8%的患者报告至少发生1次有症状的低血糖事件。

结论

在现实环境中,尽管开始使用了胰岛素,但仍有大量患者未能达到个体化血糖目标。其中一个原因似乎与基础胰岛素滴定不足有关。

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