Department of Clinical Pharmacy, King Khalid University, Abha, Kingdom of Saudi Arabia.
Int J Clin Pract. 2021 Mar;75(3):e13802. doi: 10.1111/ijcp.13802. Epub 2020 Nov 14.
The safety and efficacy of treatment approaches in patients with type 2 diabetes mellitus (T2DM) after the failure of two oral hypoglycemic agents (OHAs) was studied.
A combination of the ambispective study was conducted between June 2013 to June 2014 at the Asir Diabetes Center, Abha, Kingdom of Saudi Arabia (KSA). Patients with poorly controlled T2DM who were administered two OHAs for at least 6 months and had HbA1c levels greater than 7.0% were included. Subjects were treated with three OHAs (Group I), biphasic insulin and metformin (Group II), two existing OHAs and basal insulin (Group III), and insulin monotherapy (Group IV). Relevant data were collected at baseline at the interval of 3 months for one year.
Amongst 255 patients enrolled, 20.8, 29.8, 32.5, and 16.8% were in Groups I, II, III, and IV, respectively. The mean (Glycated hemoglobin) HbA1c levels were decreased significantly in the groups where insulin was an add-on therapy with the OHAs. Acceptable level of HbA1C (7 %) was significantly higher amongst patients in groups II and III, whereas hypoglycemic events were higher in Group IV.
Insulin as add-on therapy with OHAs is an option for the management of T2DM where glycemic control is insufficient with two OHAs.
研究两种口服降糖药(OHA)治疗失败后 2 型糖尿病(T2DM)患者的治疗方法的安全性和有效性。
2013 年 6 月至 2014 年 6 月在沙特阿拉伯王国阿西尔糖尿病中心进行了前瞻性研究。纳入的患者为接受两种 OHA 治疗至少 6 个月且糖化血红蛋白(HbA1c)水平大于 7.0%的血糖控制不佳的 T2DM 患者。受试者接受三种 OHA(I 组)、双相胰岛素和二甲双胍(II 组)、两种现有 OHA 和基础胰岛素(III 组)和胰岛素单药治疗(IV 组)。在基线时收集相关数据,并在一年的 3 个月间隔内进行随访。
在纳入的 255 名患者中,I、II、III 和 IV 组分别占 20.8%、29.8%、32.5%和 16.8%。在添加胰岛素的 OHA 治疗组中,HbA1c 水平(糖化血红蛋白)均显著降低。HbA1C 水平(7%)在 II 组和 III 组的患者中显著更高,而 IV 组低血糖事件更高。
对于两种 OHA 血糖控制不足的 T2DM 患者,胰岛素作为 OHA 的附加治疗是一种选择。