Deerochanawong Chaicharn, Leelawattana Rattana, Kosachunhanun Natapong, Tantiwong Puntip
Diabetes and Endocrinology Unit, Department of Medicine, Rajavithi Hospital, College of Medicine, Rangsit University, Krung Thep Maha Nakhon, Thailand.
Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Prince of Songkla University Hospital, Hat Yai, Thailand.
Clin Med Insights Endocrinol Diabetes. 2020 Jul 29;13:1179551420935930. doi: 10.1177/1179551420935930. eCollection 2020.
This multicenter, longitudinal, descriptive, observational study of T2DM adults in Thailand aimed to assess real-world outcomes of basal insulin (BI) dose titration on glycemic control. Three-hundred and twenty-four patients were recruited and followed up over 24 weeks. Basal insulin titration was physician-driven in 58.2% of patients and patient-driven in the rest. During the 24-week study period, the total daily BI dose moved from 20.9 to 25.6 in the physician-driven group, while in the patient-driven group, it increased from 25.3 to 29.7. Thirty-five patients (11.2%) achieved their individualized HbA1c targets, with 18 patients (5.8%) achieving HbA1c ⩽ 7% without documented hypoglycemia. In summary, this study highlights that BI titration is suboptimal in the real world, and patients are unable to achieve their glycemic targets.
这项针对泰国2型糖尿病成年人的多中心、纵向、描述性观察性研究旨在评估基础胰岛素（BI）剂量滴定对血糖控制的实际效果。招募了324名患者并进行了24周的随访。58.2%的患者由医生主导基础胰岛素滴定，其余患者由患者自行滴定。在为期24周的研究期间，医生主导组的每日BI总剂量从20.9增至25.6，而患者自行滴定组则从25.3增至29.7。35名患者（11.2%）达到了个体化糖化血红蛋白（HbA1c）目标，其中18名患者（5.8%）在无低血糖记录的情况下达到了HbA1c≤7%。总之，本研究强调在现实世界中BI滴定并不理想，患者无法实现其血糖目标。
