探索连续血糖监测和抗糖尿病药物联合应用于不使用胰岛素的2型糖尿病患者的血糖控制

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM
Poorva M. Nemlekar, Katia L. Hannah, Courtney R. Green, Gregory J. Norman
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引用次数: 0

摘要

连续血糖监测(CGM)提供了一个详细的血糖管理视图,潜在地提高非胰岛素,抗糖尿病药物的有效性。本研究旨在评估在不使用胰岛素的2型糖尿病患者中,CGM与抗糖尿病药物联合使用是否与A1c变化相关。材料和方法本研究对来自Optum临床信息学数据集市数据库的行政索赔和相关实验室数据进行回顾性、观察性分析。研究观察期为2018年7月1日至2023年6月30日,基线期和随访期为6个月。CGM需要与五种抗糖尿病药物中的≥一种联合使用:二甲双胍、磺脲类药物、钠-葡萄糖共转运蛋白-2 (SGLT2)抑制剂、二肽基肽酶-4 (DPP-4)抑制剂和/或胰高血糖素样肽-1受体激动剂(GLP-1 RAs)。主要终点是A1c较基线的变化。线性回归模型检验了CGM与各种抗糖尿病药物的主效应和交互效应。总体而言,52,394名CGM-naïve成人非胰岛素治疗2型糖尿病患者使用抗糖尿病药物(4086名CGM使用者;48,308名CGM非使用者)。与未使用CGM的患者相比,使用CGM的患者的糖化血红蛋白变化增加-0.45% (p < 0.0001)。在调整协变量后,使用CGM的患者与不使用CGM的患者相比,在使用所有药物的情况下,A1c降低幅度更大,但统计学上显著的相互作用表明,对于DPP-4抑制剂、GLP-1 RAs和磺脲类药物,使用CGM的患者与不使用CGM的患者相比,使用CGM的患者与不使用CGM的患者相比,使用CGM的患者与不使用CGM的患者相比,A1c降低幅度更大。使用CGM的患者与未使用CGM的患者之间的A1c变化不因使用二甲双胍或SGLT2抑制剂而变化。研究结果表明,在非胰岛素治疗的2型糖尿病患者中,使用CGM可以增加抗糖尿病药物的降糖益处。这些结果支持更广泛地采用CGM。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Exploring Combined Use of Continuous Glucose Monitoring and Anti-Diabetes Medications on Glycaemic Control for People With Type 2 Diabetes Not Using Insulin

Exploring Combined Use of Continuous Glucose Monitoring and Anti-Diabetes Medications on Glycaemic Control for People With Type 2 Diabetes Not Using Insulin

Introduction

Continuous glucose monitoring (CGM) offers a detailed view of glycaemic management, potentially enhancing the effectiveness of non-insulin, anti-diabetes medications. This study aimed to evaluate whether CGM use in combination with anti-diabetes medications is associated with changes in A1c among people with type 2 diabetes not using insulin.

Materials and Methods

This was a retrospective, observational analysis of administrative claims and linked laboratory data from Optum's Clinformatics Data Mart database. The study observation period covered 01/07/2018 through 30/06/2023 with 6-month baseline and follow-up periods. CGM use in conjunction with ≥ 1 of five anti-diabetes medication classes: metformin, sulfonylureas, sodium-glucose cotransporter-2 (SGLT2) inhibitors, dipeptidyl peptidase-4 (DPP-4) inhibitors and/or glucagon-like peptide-1 receptor agonists (GLP-1 RAs) was required. The primary outcome was change in A1c from baseline. Linear regression models tested the main and interaction effects of CGM and each anti-diabetes medication.

Results

Overall, 52,394 CGM-naïve adults with non-insulin-treated type 2 diabetes using anti-diabetes medications were identified (4086 CGM users; 48,308 CGM non-users). CGM use was associated with a –0.45% greater A1c change among CGM users compared to CGM non-users (p < 0.0001). After adjusting for covariates, CGM users experienced greater A1c reductions vs. CGM non-users with all medications, but statistically significant interactions showed that for DPP-4 inhibitors, GLP-1 RAs and sulfonylureas, there were greater decreases in A1c for CGM users vs. CGM non-users who were taking the medication compared to CGM users vs. CGM non-users who were not taking the medication. A1c change between CGM users vs. CGM non-users did not vary by metformin or SGLT2 inhibitor use.

Discussion

The findings suggest that CGM use could augment the glycaemic benefits of anti-diabetes medications in people with non-insulin treated type 2 diabetes. These results support broader adoption of CGM.

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来源期刊
Endocrinology, Diabetes and Metabolism
Endocrinology, Diabetes and Metabolism Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
5.00
自引率
0.00%
发文量
66
审稿时长
6 weeks
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