Cowart Kevin, Vascimini Angelina, Kumar Ambuj, Tsalatsanis Athanasios, Saba Yalda, Carris Nicholas W
USF Health Taneja College of Pharmacy, University of South Florida, Tampa, FL.
USF Health Morsani College of Medicine, University of South Florida, Tampa, FL.
Clin Diabetes. 2023 Spring;41(2):147-153. doi: 10.2337/cd22-0046. Epub 2022 Jul 12.
The American Diabetes Association's emphasize the need for awareness regarding overbasalization (basal insulin doses >0.5 units/kg/day without bolus insulin) in the treatment of type 2 diabetes. However, outcomes data on the impact of overbasalization are limited. This post hoc analysis of a large randomized controlled trial suggests that an insulin therapy regimen involving overbasalization compared with a basal-bolus insulin regimen that avoids overbasalization is less effective at lowering A1C and may be associated with increased cardiovascular risk. Clinicians should consider alternative approaches to glycemic control before increasing basal insulin doses to >0.5 units/kg/day.
美国糖尿病协会强调在2型糖尿病治疗中需提高对基础胰岛素过量(基础胰岛素剂量>0.5单位/千克/天且无追加胰岛素)的认识。然而,关于基础胰岛素过量影响的结局数据有限。这项对一项大型随机对照试验的事后分析表明,与避免基础胰岛素过量的基础-餐时胰岛素方案相比,包含基础胰岛素过量的胰岛素治疗方案在降低糖化血红蛋白方面效果较差,且可能与心血管风险增加有关。临床医生在将基础胰岛素剂量增加至>0.5单位/千克/天之前,应考虑其他血糖控制方法。