Endocrinology and Nutrition, University Hospital of Puerto Real, Puerto Real, Andalucía, Spain
Endocrinology and Nutrition, University Hospital of Puerto Real, Puerto Real, Andalucía, Spain.
J Investig Med. 2021 Jun;69(5):983-988. doi: 10.1136/jim-2020-001633. Epub 2021 Mar 26.
There are not many real-world studies evaluating daily insulin doses requirements (DIDR) in patients with type 1 diabetes (T1D) using second-generation basal insulin analogs, and such comparison is necessary. The aim of this study was to compare DIDR in individuals with T1D using glargine 300 UI/mL (IGlar-300) or degludec (IDeg) in real clinical practice. An observational, retrospective study was designed in 412 patients with T1D (males: 52%; median age 37.0±13.4 years, diabetes duration: 18.7±12.3 years) using IDeg and IGla-300 ≥6 months to compare DIDR between groups. Patients using IGla-300 (n=187) were more frequently males (59% vs 45.8%; p=0.004) and had lower glycosylated hemoglobin (HbA1c) (7.6±1.2 vs 8.1%±1.5%; p<0.001) than patients using IDeg (n=225). Total (0.77±0.36 unit/kg/day), basal (0.43±0.20 unit/kg/day) and prandial (0.33±0.23 unit/kg/day) DIDR were similar in IGla-300 and IDeg groups. Patients with HbA1c ≤7% (n=113) used significantly lower basal (p=0.045) and total (p=0.024) DIDR, but not prandial insulin (p=0.241), than patients with HbA1c between 7.1% and 8% and >8%. Patients using IGla-300 and IDeg used similar basal, prandial and total DIDR regardless of metabolic control subgroup. No difference in basal, prandial and total DIDR was observed between patients with T1D using IGla-300 or IDeg during at least 6 months in routine clinical practice.
在使用第二代基础胰岛素类似物的 1 型糖尿病 (T1D) 患者中,很少有真实世界的研究评估每日胰岛素剂量需求 (DIDR),因此有必要进行此类比较。本研究的目的是比较使用甘精胰岛素 300IU/mL (IGlar-300) 或德谷胰岛素 (IDeg) 的 T1D 个体的 DIDR,这两种药物均为第二代基础胰岛素类似物。本研究设计了一项观察性、回顾性研究,纳入了 412 名至少使用 6 个月 IDeg 和 IGla-300 的 T1D 患者(男性:52%;中位年龄 37.0±13.4 岁,糖尿病病程:18.7±12.3 年),比较两组间 DIDR。使用 IGla-300(n=187)的患者中男性更常见(59%比 45.8%;p=0.004),糖化血红蛋白 (HbA1c) 更低(7.6±1.2%比 8.1%±1.5%;p<0.001)。IGla-300 组和 IDeg 组的总 DIDR(0.77±0.36 单位/公斤/天)、基础 DIDR(0.43±0.20 单位/公斤/天)和餐时 DIDR(0.33±0.23 单位/公斤/天)相似。HbA1c≤7%(n=113)的患者基础 DIDR(p=0.045)和总 DIDR(p=0.024)显著降低,但餐时胰岛素未降低(p=0.241),而 HbA1c 在 7.1%和 8%之间和>8%的患者则未降低。在代谢控制亚组中,使用 IGla-300 和 IDeg 的患者基础、餐时和总 DIDR相似。在常规临床实践中,至少使用 6 个月 IGla-300 和 IDeg 的 T1D 患者的基础、餐时和总 DIDR无差异。