Malighetti Maria Elena, Molteni Laura, Orsi Emanuela, Serra Roberta, Gaglio Alessia, Mazzoleni Federica, Russo Filomena, Bossi Antonio Carlo
Casa di Cura Ambrosiana - Piazza Monsignor Moneta 1, 20090, Cesano Boscone (MI), Italy.
Ospedale Sacra Famiglia Fatebenefratelli - via Fatebenefratelli 20, 22036, Erba (CO), Italy.
Acta Diabetol. 2025 Mar;62(3):367-374. doi: 10.1007/s00592-024-02361-7. Epub 2024 Sep 5.
To assess the effects of IDegLira on glucometric indices deriving from intermittently scanned Continuous Glucose Monitoring (isCGM) in patients with type 2 diabetes (T2D).
Retrospective, observational, cohort, multi-center, "pre - post" study. All adults consecutively identified in the medical records who started treatment with IDegLira, and for whom an isCGM report before and after the initiation of IDegLira was available were included in the study. Time in range (TIR) represented the primary endpoint. Additional glucometric indices, insulin doses and body weight were also assessed.
Overall, 87 patients were included by 5 diabetes centers [mean age 70.2 ± 11.0 years, mean duration of T2D 15.5 ± 9.6 years; BMI 29.4 ± 5.4 kg/m, baseline HbA1c 9.1 ± 2.1%, 33% insulin naïve, 20.7% treated with basal-oral therapy (BOT), and 46% treated with multiple daily injections of insulin (MDI)]. After an average of 1.7 weeks from IDegLira initiation, TIR significantly increased from 56.8 ± 23.5% to 81.3 ± 13.5% (p < 0.0001), TAR decreased from 42.3 ± 24.2% to 17.1 ± 13.6% (p < 0.0001), while TBR remained steadily low (from 1.3 ± 2.3% to 1.4 ± 2.6%; p = 0.62). Estimated HbA1c decreased from 9.1 ± 2.1% to 6.7 ± 0.6% (p < 0.0001) and percentage of patients with a blood glucose coefficient of variation ≥ 36% dropped from 33.2 to 13.8% (p = 0.0005). In patients on MDI, the reduction in the total insulin dose was substantial (from 55.8 ± 31.2 IU to 27.2 ± 12.3 U).
In T2D patients with poor metabolic control, either insulin naïve or treated with BOT or MDI, the introduction of IDegLira produces a significant increase in the time spent in good metabolic control and a marked reduction in glycemic fluctuations.
评估德谷胰岛素利拉鲁肽（IDegLira）对2型糖尿病（T2D）患者间歇性扫描式动态血糖监测（isCGM）得出的血糖指标的影响。
回顾性、观察性、队列、多中心“治疗前 - 治疗后”研究。纳入所有在病历中连续识别出的开始使用IDegLira治疗且有IDegLira治疗前和治疗后isCGM报告的成年人。血糖达标时间（TIR）为主要终点。还评估了其他血糖指标、胰岛素剂量和体重。
总体而言，5个糖尿病中心共纳入87例患者[平均年龄70.2±11.0岁，T2D平均病程15.5±9.6年；体重指数（BMI）29.4±5.4kg/m²，基线糖化血红蛋白（HbA1c）9.1±2.1%，33%患者未使用过胰岛素，20.7%患者接受基础口服治疗（BOT），46%患者接受每日多次胰岛素注射（MDI）治疗]。开始使用IDegLira平均1.7周后，TIR从56.8±23.5%显著增加至81.3±13.5%（p<0.0001），高血糖时间（TAR）从42.3±24.2%降至17.1±13.6%（p<0.0001），而低血糖时间（TBR）保持稳定在较低水平（从1.3±2.3%至1.4±2.6%；p = 0.62）。估计的HbA1c从9.1±2.1%降至6.7±0.6%（p<0.0001），血糖变异系数≥36%的患者百分比从33.2%降至13.8%（p = 0.0005）。在接受MDI治疗的患者中，总胰岛素剂量大幅减少（从55.8±31.2 IU降至27.2±12.3 U）。
在代谢控制不佳的T2D患者中，无论未使用过胰岛素还是接受BOT或MDI治疗，引入IDegLira都会使良好代谢控制时间显著增加，血糖波动明显减少。
