Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, China.
Diabetes Metab Res Rev. 2023 May;39(4):e3615. doi: 10.1002/dmrr.3615. Epub 2023 Feb 2.
To examine whether simple clinical features can predict the 1-year glycaemic response to glucose-lowering drugs (GLDs) among Chinese with type 2 diabetes.
We used data from a diabetes risk assessment and complication screening programme and electronic medical records. We used linear regression models to examine the association between clinical features and 1-year glycaemic response to GLDs.
Use of metformin (n = 15,433), sulphonylureas (SU) (n = 15,190), dipeptidyl peptidase-4 inhibitor (DPP-4i) (n = 7947), thiazolidinedione (TZD) (n = 4107), and sodium-glucose cotransporter 2 inhibitors (SGLT-2i) (n = 1883) were associated with a mean reduction of HbA1c ranging from 0.7% to 1.3% at one year. Men had a greater response to SU but a poorer response to metformin and TZD. Older age predicted a better response to all GLDs but not SGLT-2i, whereas increasing diabetes duration was associated with a poorer response to all GLDs except for DPP-4i. Obese patients responded greater to TZD and SGLT-2i but poorer to SU than those with normal weight. Patients with a higher level of triglycerides to high-density lipoprotein cholesterol ratio had a greater glycaemic response to TZD but a smaller response to SU and DPP-4i.
Glycaemic response to GLDs differed considerably by clinical features among Chinese patients with type 2 diabetes.
研究中国 2 型糖尿病患者的简单临床特征是否可预测其使用降糖药物（GLD）治疗 1 年后的血糖变化。
我们使用了糖尿病风险评估和并发症筛查项目以及电子病历的数据。我们使用线性回归模型来研究临床特征与 GLD 治疗 1 年后血糖变化的相关性。
使用二甲双胍（n=15433）、磺脲类药物（SU）（n=15190）、二肽基肽酶-4 抑制剂（DPP-4i）（n=7947）、噻唑烷二酮（TZD）（n=4107）和钠-葡萄糖协同转运蛋白 2 抑制剂（SGLT-2i）（n=1883）的患者，1 年后糖化血红蛋白（HbA1c）平均降低 0.7%至 1.3%。男性对 SU 的反应更大，但对二甲双胍和 TZD 的反应较差。年龄越大，对所有 GLD 的反应越好，但对 SGLT-2i 则不然，而糖尿病病程的延长与所有 GLD 的反应较差相关，除了 DPP-4i。肥胖患者对 TZD 和 SGLT-2i 的反应更大，但对 SU 的反应比对体重正常的患者更差。三酰甘油与高密度脂蛋白胆固醇比值较高的患者对 TZD 的降糖作用反应更大，但对 SU 和 DPP-4i 的反应较小。
中国 2 型糖尿病患者的 GLD 降糖反应因临床特征而异。
