Zhang Qiumei, Fan Yaqing, Liu Xixi, Zhang Minlu, Zhang Jiewen, Du Qin, Kang Lei, Chen Liming
NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China.
Sanofi Investment Co., Ltd., Shanghai, China.
J Diabetes Investig. 2025 May;16(5):842-851. doi: 10.1111/jdi.14415. Epub 2025 Feb 3.
To evaluate characteristics and glycemic outcomes in individuals with type 2 diabetes using injectable therapies in real-world clinical practice in Tianjin, China.
Data from inpatients and outpatients receiving injectable therapies between January 2015 and December 2019 were collected from the Tianjin regional electronic medical records and retrospectively analyzed. Seven cohorts were identified, including individuals initiating injectable therapies (premixed insulin [n = 4,687], basal insulin [4,177], or glucagon-like peptide-1 receptor agonists [541]) or switching injectable therapies (premixed insulin to basal insulin [1,298], basal insulin to premixed insulin [1,457], basal insulin to basal + bolus insulin [1,772], or glucagon-like peptide-1 receptor agonists to basal insulin ± glucagon-like peptide-1 receptor agonists [82]).
In participants initiating therapy, glycated hemoglobin and fasting plasma glucose were highest in the basal insulin cohort, while among participants switching therapy, the highest values were in the basal insulin ± glucagon-like peptide-1 receptor agonists cohort. Initiating therapy with premixed or basal insulin and switching from basal insulin to basal + bolus insulin improved glycemic control over 12 months. A mean delay in initiating therapy of up to 13 months after oral glucose-lowering drug failure was observed, with 60% having a delay of >6 months. This delay was associated with a lower proportion achieving glycemic control 3 months after initiation.
Effectiveness was not observed at all time points in all cohorts, suggesting some treatments were not used in the appropriate population. Delays in initiating injectable therapies were observed and were associated with poor glycemic control.
在中国天津的实际临床实践中，评估使用注射疗法的2型糖尿病患者的特征和血糖结局。
收集2015年1月至2019年12月接受注射疗法的住院患者和门诊患者的数据，这些数据来自天津地区电子病历，并进行回顾性分析。确定了七个队列，包括开始注射疗法的个体（预混胰岛素[n = 4,687]、基础胰岛素[4,177]或胰高血糖素样肽-1受体激动剂[541]）或转换注射疗法的个体（预混胰岛素转换为基础胰岛素[1,298]、基础胰岛素转换为预混胰岛素[1,457]、基础胰岛素转换为基础+餐时胰岛素[1,772]或胰高血糖素样肽-1受体激动剂转换为基础胰岛素±胰高血糖素样肽-1受体激动剂[82]）。
在开始治疗的参与者中，基础胰岛素队列的糖化血红蛋白和空腹血糖最高，而在转换治疗的参与者中，基础胰岛素±胰高血糖素样肽-1受体激动剂队列的值最高。开始使用预混或基础胰岛素治疗以及从基础胰岛素转换为基础+餐时胰岛素可在12个月内改善血糖控制。观察到口服降糖药失效后开始治疗平均延迟长达13个月，60%的患者延迟超过6个月。这种延迟与开始治疗3个月后实现血糖控制的比例较低有关。
并非在所有队列的所有时间点都观察到有效性，这表明某些治疗未在合适的人群中使用。观察到开始注射疗法存在延迟，且与血糖控制不佳有关。
