Güneş E, Güneş M
Department of Endocrinology, Metabolism and Diabetes, Health Sciences University, Bursa State Hospital, Bursa, Turkey.
Eur Rev Med Pharmacol Sci. 2023 Jul;27(14):6691-6699. doi: 10.26355/eurrev_202307_33139.
The aim of this study was to evaluate the efficacy of twice-daily (BID) insulin degludec/insulin aspart (IDegAsp) co-formulation + once-daily (OD) bolus insulin aspart (IAsp) injection (IDegAsp BID-Plus) as simplified intensive insulin therapy in patients with poorly controlled type 2 diabetes mellitus (T2DM) with basal-bolus insulin therapy (BBIT).
The retrospective study included 155 patients who switched from BBIT to IDegAsp BID-Plus. After the initiation of the treatment, 73 patients continued regular follow-up and insulin doses, number of injections, hemoglobin A1c (HbA1c) levels, and other parameters were recorded from their files at baseline, 24, and 52 weeks.
The mean age of the study population was 54.3±10.2 years, the duration of T2DM was 9.7±5.7 years, fasting plasma glucose (FPG) was 252.7±66.7 mg/dl, and HbA1c levels were 10.5±1.5%. Among the included patients, 15 patients received five injections, 51 patients received four injections, and 7 patients received three injections per day. There was a significant decrease in HbA1c (respectively; 10.46±1.54%, 7.97±1.24%, 7.98±1.23%, baseline and 6th-month p<0.001, baseline and 12th-month p<0.001), FPG (respectively; 251.6±66.5 mg/dl, 136.1±34.7 mg/dl, 125.4±67.0 mg/dl, baseline and 6th-month p<0.001, baseline and 12th-month p<0.001) and daily dose of insulin (respectively; 102.9±29.0 Unit, 73.2±18.2 U, 63.7±20.3 Unit, baseline and 6th-month p<0.001, baseline and 12th-month p<0.001) at the end of week 24 and 52.
Based on real-world data, this study demonstrated that IDegAsp BID-Plus treatment provides rapid and sustainable blood glucose control with lower insulin doses and fewer injections than previous intensive insulin therapy.
本研究旨在评估每日两次（BID）的德谷胰岛素/门冬胰岛素（IDegAsp）复方制剂联合每日一次（OD）的门冬胰岛素（IAsp）推注（IDegAsp BID-Plus）作为简化强化胰岛素治疗方案，用于基础-餐时胰岛素治疗（BBIT）控制不佳的2型糖尿病（T2DM）患者的疗效。
这项回顾性研究纳入了155例从BBIT转换为IDegAsp BID-Plus治疗的患者。治疗开始后，73例患者继续接受常规随访，并从其病历中记录基线、24周和52周时的胰岛素剂量、注射次数、糖化血红蛋白（HbA1c）水平及其他参数。
研究人群的平均年龄为54.3±10.2岁，T2DM病程为9.7±5.7年，空腹血糖（FPG）为252.7±66.7mg/dl，HbA1c水平为10.5±1.5%。在纳入的患者中，15例患者每日接受5次注射，51例患者每日接受4次注射，7例患者每日接受3次注射。在第24周和52周结束时，HbA1c（分别为：基线时10.46±1.54%、第6个月时7.97±1.24%、第12个月时7.98±1.23%，基线与第6个月相比p<0.001，基线与第12个月相比p<0.001）、FPG（分别为：基线时251.6±66.5mg/dl、第6个月时136.1±34.7mg/dl、第12个月时125.4±67.0mg/dl，基线与第6个月相比p<0.001，基线与第12个月相比p<0.001）和胰岛素每日剂量（分别为：基线时102.9±29.0单位、第6个月时73.2±18.2U、第12个月时63.7±20.3单位，基线与第6个月相比p<0.001，基线与第12个月相比p<0.001）均显著下降。
基于真实世界数据，本研究表明，与之前的强化胰岛素治疗相比，IDegAsp BID-Plus治疗能以更低的胰岛素剂量和更少的注射次数实现快速且可持续的血糖控制。
