礼来互联关怀项目在中国 2 型糖尿病患者中的血糖管理改善效果：回顾性真实世界研究。

Effectiveness of the Lilly Connected Care Program in Improving Glycemic Management Among Patients With Type 2 Diabetes in China: Retrospective Real-world Study.

机构信息

Department of Endocrinology, The Second Hospital of Dalian Medical University, Dalian, China.

Department of Endocrinology, The Second Hospital of Tianjin Medical University, Tianjin, China.

出版信息

J Med Internet Res. 2023 Apr 25;25:e38680. doi: 10.2196/38680.

DOI:10.2196/38680

PMID:37097724

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10170357/

Abstract

BACKGROUND

Type 2 diabetes mellitus (T2DM) is a worldwide public health concern. Mobile health management platforms could be a potential way to achieve effective glycemic control.

OBJECTIVE

This study aimed to evaluate the real-world effectiveness of the Lilly Connected Care Program (LCCP) platform in glycemic control among patients with T2DM in China.

METHODS

This retrospective study included Chinese patients with T2DM (aged ≥18 years) from April 1, 2017, to January 31, 2020, for the LCCP group and from January 1, 2015, to January 31, 2020, for the non-LCCP group. Propensity score matching was used to match the LCCP and non-LCCP groups to reduce confounding, with covariates including age, sex, the duration of diabetes, baseline hemoglobin A (HbA), and the number of oral antidiabetic medication classes. HbA reduction over 4 months, the proportions of patients achieving an HbA reduction of ≥0.5% or ≥1%, and the proportions of patients reaching to target HbA level of ≤6.5% or <7% were compared between the LCCP and non-LCCP groups. Multivariate linear regression was used to assess factors associated with HbA reduction.

RESULTS

A total of 923 patients were included, among whom 303 pairs of patients were well matched after propensity score matching. HbA reduction during the 4-month follow-up was significantly larger in the LCCP group than the non-LCCP group (mean 2.21%, SD 2.37% vs mean 1.65%, SD 2.29%; P=.003). The LCCP group had a higher proportion of patients with an HbA reduction of ≥1% (209/303, 69% vs 174/303, 57.4%; P=.003) and ≥0.5% (229/303, 75.6% vs 206/303, 68%; P=.04). The proportions of patients reaching the target HbA level of ≤6.5% were significantly different between the LCCP and non-LCCP groups (88/303, 29% vs 61/303, 20.1%; P=.01), whereas the difference in the proportions of patients reaching the target HbA level of <7% was not statistically significant (LCCP vs non-LCCP: 128/303, 42.2% vs 109/303, 36%; P=.11). LCCP participation and higher baseline HbA were associated with a larger HbA reduction, whereas older age, longer diabetes duration, and higher baseline dose of premixed insulin analogue were associated with a smaller HbA reduction.

CONCLUSIONS

The LCCP mobile platform was effective in glycemic control among patients with T2DM in China in the real world.

摘要

背景

2 型糖尿病（T2DM）是一个全球性的公共卫生问题。移动医疗管理平台可能是实现有效血糖控制的一种潜在方法。

目的

本研究旨在评估 Lilly Connected Care Program（LCCP）平台在中国 T2DM 患者中的血糖控制的真实世界疗效。

方法

本回顾性研究纳入了 2017 年 4 月 1 日至 2020 年 1 月 31 日期间参加 LCCP 的中国 T2DM 患者（年龄≥18 岁），以及 2015 年 1 月 1 日至 2020 年 1 月 31 日期间未参加 LCCP 的患者。采用倾向评分匹配（PSM）来匹配 LCCP 和非 LCCP 组，以减少混杂因素，协变量包括年龄、性别、糖尿病病程、基线糖化血红蛋白（HbA）和口服抗糖尿病药物种类。比较 LCCP 和非 LCCP 组在 4 个月随访期间的 HbA 降低情况、HbA 降低≥0.5%或≥1%的患者比例以及达到目标 HbA 水平（≤6.5%或<7%）的患者比例。采用多变量线性回归评估与 HbA 降低相关的因素。

结果

共纳入 923 例患者，其中 303 对患者经 PSM 后匹配良好。LCCP 组在 4 个月随访期间的 HbA 降低幅度显著大于非 LCCP 组（平均 2.21%，SD 2.37% vs 平均 1.65%，SD 2.29%；P=.003）。LCCP 组 HbA 降低≥1%的患者比例（209/303，69%）显著高于非 LCCP 组（174/303，57.4%；P=.003），HbA 降低≥0.5%的患者比例（229/303，75.6%）也显著高于非 LCCP 组（206/303，68%；P=.04）。LCCP 组达到目标 HbA 水平（≤6.5%）的患者比例显著高于非 LCCP 组（88/303，29%），而达到目标 HbA 水平（<7%）的患者比例差异无统计学意义（LCCP 组 vs 非 LCCP 组：128/303，42.2% vs 109/303，36%；P=.11）。LCCP 参与和较高的基线 HbA 与 HbA 降低幅度较大相关，而年龄较大、糖尿病病程较长和较高的基线预混胰岛素类似物剂量与 HbA 降低幅度较小相关。