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在真实世界中,1 型和 2 型糖尿病患者从其他基础胰岛素转换为德谷胰岛素和甘精胰岛素 300U/mL 后的临床结局比较。

Comparative clinical outcomes of insulin degludec and insulin glargine 300 U/mL after switching from other basal insulins in real-world patients with type 1 and type 2 diabetes.

机构信息

Diabetes Center, Tokyo Women's Medical University, Tokyo, Japan.

出版信息

J Diabetes Investig. 2021 Nov;12(11):1983-1991. doi: 10.1111/jdi.13559. Epub 2021 May 3.

Abstract

AIMS/INTRODUCTION: To evaluate and compare the efficacy of insulin degludec (IDeg) and insulin glargine 300 U/mL (Gla300) 6 months after switching from other basal insulins by assessing the changes in glycated hemoglobin (HbA1c), body mass index (BMI), and insulin doses in patients with type 1 and type 2 diabetes in a real-world clinical setting.

MATERIALS AND METHODS

A total of 307 patients with type 1 diabetes and 294 patients with type 2 diabetes with HbA1c >7.0% were studied. Adjusted mean changes in HbA1c, BMI, and insulin doses were compared between IDeg (IDeg group) and Gla300 (Gla300 group) switchers. Multivariable logistic regression analyses were carried out to examine whether the IDeg or Gla300 group was associated with HbA1c or insulin dose reduction and BMI gain.

RESULTS

HbA1c was significantly decreased in both the IDeg and Gla300 groups. Adjusted mean changes in HbA1c (approximately -0.3% and -0.5% in type 1 diabetes and type 2 diabetes patients, respectively) and BMI were similar between both groups. The mean change in insulin dose was slightly larger for dose reduction in the IDeg group than in the Gla300 group. Multivariable logistic regression models showed that the IDeg group was significantly associated with insulin dose reduction after adjusting for basal insulin type, insulin dose, and number of basal insulin injections at baseline and other confounding factors.

CONCLUSIONS

The current study suggested that IDeg and Gla300 have similar effects in reducing HbA1c and gaining BMI after switching from other basal insulins in Japanese patients with type 1 diabetes and type 2 diabetes. IDeg selection was associated with insulin dose reduction.

摘要

目的/引言:在真实临床环境中,评估并比较 1 型和 2 型糖尿病患者转换用其他基础胰岛素治疗后 6 个月时,德谷胰岛素(IDeg)和甘精胰岛素 300U/ml(Gla300)的疗效,通过糖化血红蛋白(HbA1c)、体重指数(BMI)和胰岛素剂量的变化来评估。

材料和方法

共纳入 307 例 1 型糖尿病和 294 例 2 型糖尿病患者,HbA1c>7.0%。比较 IDeg(IDeg 组)和 Gla300(Gla300 组)转换者之间 HbA1c、BMI 和胰岛素剂量的调整平均变化。进行多变量逻辑回归分析,以检验 IDeg 或 Gla300 组与 HbA1c 或胰岛素剂量减少和 BMI 增加相关。

结果

IDeg 和 Gla300 组的 HbA1c 均显著降低。两组患者的 HbA1c(1 型和 2 型糖尿病患者的调整平均变化分别约为-0.3%和-0.5%)和 BMI 变化相似。与 Gla300 组相比,IDeg 组的胰岛素剂量调整平均变化稍大,提示剂量减少。多变量逻辑回归模型显示,在调整基础胰岛素类型、胰岛素剂量以及基线时基础胰岛素注射次数和其他混杂因素后,IDeg 组与胰岛素剂量减少显著相关。

结论

本研究表明,在日本 1 型和 2 型糖尿病患者转换用其他基础胰岛素治疗后,IDeg 和 Gla300 降低 HbA1c 和增加 BMI 的作用相似。IDeg 的选择与胰岛素剂量减少有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59f3/8565408/380918bd5604/JDI-12-1983-g002.jpg

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