{"title":"基础餐胰岛素方案治疗2型糖尿病患者的疗效","authors":"Francisco Javier García-Soidán","doi":"10.1016/j.avdiab.2013.01.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p><span>Premixed insulins are a common treatment for type 2 diabetes mellitus (DM). However, their limitations and the lack of achieving </span>glycaemic control in some patients reinforce the need to find therapeutic alternatives.</p></div><div><h3>Objectives</h3><p><span>To assess whether basal–prandial therapy (basal insulin, and additional pre-prandial rapid insulin boluses, when required) improves glycaemic control in patients<span> with type 2 DM and glycosylated haemoglobin (HbA1c) >53</span></span> <span>mmol/mol (7%) treated with premixed insulin in the primary care setting.</span></p></div><div><h3>Material and methods</h3><p><span>A retrospective observational study in which 116 patients with type 2 DM switched from premixed insulin to basal–prandial therapy. Data on demographics, anthropometrics, laboratory results, and </span>antidiabetic treatment were collected from the medical charts of the patients, prior to switching the treatment (baseline) and 4 months thereafter.</p></div><div><h3>Results</h3><p><span>HbA1c significantly decreased from baseline to month 4 (65.1</span> <!-->±<!--> <!-->5.7<!--> <!-->mmol/mol [8.1<!--> <!-->±<!--> <!-->0.5%] versus 51.9<!--> <!-->±<!--> <!-->7.2<!--> <!-->mmol/mol [6.9<!--> <!-->±<!--> <!-->0.7%]; <em>p</em> <!--><<!--> <!-->.005), and 70 patients (60.9%) had an HbA1c ≤53<!--> <span>mmol/mol (7%). Additionally, fasting blood glucose (FBG) significantly decreased (9.7</span> <!-->±<!--> <!-->1.7<!--> <!-->mmol/l [175.4<!--> <!-->±<!--> <!-->31.2<!--> <!-->mg/dl] versus 6.9<!--> <!-->±<!--> <!-->1.4<!--> <!-->mmol/l [124.4<!--> <!-->±<!--> <!-->25.8<!--> <!-->mg/dl]; <em>p</em> <!--><<!--> <!-->.005), and the number of patients with FBG<!--> <!--><<!--> <!-->5.6<!--> <!-->mmol/l (100<!--> <!-->mg/dl) (2 patients [1.7%] versus 21 patients [18.3%]; <em>p</em> <!--><<!--> <!-->.005), and with post-prandial blood glucose ≤10<!--> <!-->mmol/l (180<!--> <!-->mg/dl) (14 patients, [12.1%] versus 87 patients [76.3%]; <em>p</em> <!--><<!--> <!-->.05) significantly increased. There were also significant decreases in body weight (76.3<!--> <!-->±<!--> <!-->12.9<!--> <!-->kg versus 74.8<!--> <!-->±<!--> <!-->12.5<!--> <!-->kg; <em>p</em> <!--><<!--> <!-->.001) and waist circumference (96.1<!--> <!-->±<!--> <!-->16.0<!--> <!-->cm versus 94.4<!--> <!-->±<!--> <!-->14.5<!--> <!-->cm; <em>p</em> <!--><<!--> <!-->.005). Only 4 patients (3.5%) had hypoglycaemia.</p></div><div><h3>Conclusions</h3><p>Basal–prandial therapy improved glycaemic control in patients with type 2 DM, with a low incidence of hypoglycaemia, and decreased body weight.</p></div>","PeriodicalId":100152,"journal":{"name":"Avances en Diabetología","volume":"29 1","pages":"Pages 12-18"},"PeriodicalIF":0.0000,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.avdiab.2013.01.002","citationCount":"1","resultStr":"{\"title\":\"Efficacy of treatment with a basal–prandial insulin regimen in patients with type 2 diabetes mellitus previously treated with premixed insulin\",\"authors\":\"Francisco Javier García-Soidán\",\"doi\":\"10.1016/j.avdiab.2013.01.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p><span>Premixed insulins are a common treatment for type 2 diabetes mellitus (DM). However, their limitations and the lack of achieving </span>glycaemic control in some patients reinforce the need to find therapeutic alternatives.</p></div><div><h3>Objectives</h3><p><span>To assess whether basal–prandial therapy (basal insulin, and additional pre-prandial rapid insulin boluses, when required) improves glycaemic control in patients<span> with type 2 DM and glycosylated haemoglobin (HbA1c) >53</span></span> <span>mmol/mol (7%) treated with premixed insulin in the primary care setting.</span></p></div><div><h3>Material and methods</h3><p><span>A retrospective observational study in which 116 patients with type 2 DM switched from premixed insulin to basal–prandial therapy. Data on demographics, anthropometrics, laboratory results, and </span>antidiabetic treatment were collected from the medical charts of the patients, prior to switching the treatment (baseline) and 4 months thereafter.</p></div><div><h3>Results</h3><p><span>HbA1c significantly decreased from baseline to month 4 (65.1</span> <!-->±<!--> <!-->5.7<!--> <!-->mmol/mol [8.1<!--> <!-->±<!--> <!-->0.5%] versus 51.9<!--> <!-->±<!--> <!-->7.2<!--> <!-->mmol/mol [6.9<!--> <!-->±<!--> <!-->0.7%]; <em>p</em> <!--><<!--> <!-->.005), and 70 patients (60.9%) had an HbA1c ≤53<!--> <span>mmol/mol (7%). Additionally, fasting blood glucose (FBG) significantly decreased (9.7</span> <!-->±<!--> <!-->1.7<!--> <!-->mmol/l [175.4<!--> <!-->±<!--> <!-->31.2<!--> <!-->mg/dl] versus 6.9<!--> <!-->±<!--> <!-->1.4<!--> <!-->mmol/l [124.4<!--> <!-->±<!--> <!-->25.8<!--> <!-->mg/dl]; <em>p</em> <!--><<!--> <!-->.005), and the number of patients with FBG<!--> <!--><<!--> <!-->5.6<!--> <!-->mmol/l (100<!--> <!-->mg/dl) (2 patients [1.7%] versus 21 patients [18.3%]; <em>p</em> <!--><<!--> <!-->.005), and with post-prandial blood glucose ≤10<!--> <!-->mmol/l (180<!--> <!-->mg/dl) (14 patients, [12.1%] versus 87 patients [76.3%]; <em>p</em> <!--><<!--> <!-->.05) significantly increased. There were also significant decreases in body weight (76.3<!--> <!-->±<!--> <!-->12.9<!--> <!-->kg versus 74.8<!--> <!-->±<!--> <!-->12.5<!--> <!-->kg; <em>p</em> <!--><<!--> <!-->.001) and waist circumference (96.1<!--> <!-->±<!--> <!-->16.0<!--> <!-->cm versus 94.4<!--> <!-->±<!--> <!-->14.5<!--> <!-->cm; <em>p</em> <!--><<!--> <!-->.005). Only 4 patients (3.5%) had hypoglycaemia.</p></div><div><h3>Conclusions</h3><p>Basal–prandial therapy improved glycaemic control in patients with type 2 DM, with a low incidence of hypoglycaemia, and decreased body weight.</p></div>\",\"PeriodicalId\":100152,\"journal\":{\"name\":\"Avances en Diabetología\",\"volume\":\"29 1\",\"pages\":\"Pages 12-18\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2013-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/j.avdiab.2013.01.002\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Avances en Diabetología\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1134323013000033\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Avances en Diabetología","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1134323013000033","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1
摘要
预混合胰岛素是2型糖尿病(DM)的常用治疗方法。然而，它们的局限性和在一些患者中无法实现血糖控制，加强了寻找治疗替代方案的必要性。目的评估基础餐前治疗(基础胰岛素和必要时额外的餐前快速胰岛素注射)是否能改善2型糖尿病和糖化血红蛋白(HbA1c)≤53 mmol/mol(7%)的预混胰岛素治疗患者的血糖控制。材料和方法一项回顾性观察研究，116例2型糖尿病患者从预混胰岛素转为基础膳食治疗。在转换治疗前(基线)和转换治疗后4个月，从患者的医疗图表中收集人口统计学、人体测量学、实验室结果和抗糖尿病治疗数据。结果从基线到第4个月，shba1c显著降低(65.1±5.7 mmol/mol[8.1±0.5%]和51.9±7.2 mmol/mol[6.9±0.7%];p & lt;0.005)， HbA1c≤53 mmol/mol 70例(60.9%)(7%)。此外，空腹血糖(FBG)显著降低(9.7±1.7 mmol/l[175.4±31.2 mg/dl]，而6.9±1.4 mmol/l[124.4±25.8 mg/dl];p & lt;.005)， FBG <患者人数;5.6 mmol/l (100 mg/dl)(2例[1.7%]对21例[18.3%];p & lt;0.005)，餐后血糖≤10 mmol/l (180 mg/dl)(14例，[12.1%]对87例[76.3%];p & lt;0.05)显著升高。体重也有显著下降(76.3±12.9 kg vs 74.8±12.5 kg;p & lt;0.001)和腰围(96.1±16.0 cm vs 94.4±14.5 cm;p & lt;.005)。仅有4例(3.5%)出现低血糖。结论基础餐治疗改善了2型糖尿病患者的血糖控制，低血糖发生率低，体重下降。
Efficacy of treatment with a basal–prandial insulin regimen in patients with type 2 diabetes mellitus previously treated with premixed insulin
Introduction
Premixed insulins are a common treatment for type 2 diabetes mellitus (DM). However, their limitations and the lack of achieving glycaemic control in some patients reinforce the need to find therapeutic alternatives.
Objectives
To assess whether basal–prandial therapy (basal insulin, and additional pre-prandial rapid insulin boluses, when required) improves glycaemic control in patients with type 2 DM and glycosylated haemoglobin (HbA1c) >53mmol/mol (7%) treated with premixed insulin in the primary care setting.
Material and methods
A retrospective observational study in which 116 patients with type 2 DM switched from premixed insulin to basal–prandial therapy. Data on demographics, anthropometrics, laboratory results, and antidiabetic treatment were collected from the medical charts of the patients, prior to switching the treatment (baseline) and 4 months thereafter.
Results
HbA1c significantly decreased from baseline to month 4 (65.1 ± 5.7 mmol/mol [8.1 ± 0.5%] versus 51.9 ± 7.2 mmol/mol [6.9 ± 0.7%]; p < .005), and 70 patients (60.9%) had an HbA1c ≤53 mmol/mol (7%). Additionally, fasting blood glucose (FBG) significantly decreased (9.7 ± 1.7 mmol/l [175.4 ± 31.2 mg/dl] versus 6.9 ± 1.4 mmol/l [124.4 ± 25.8 mg/dl]; p < .005), and the number of patients with FBG < 5.6 mmol/l (100 mg/dl) (2 patients [1.7%] versus 21 patients [18.3%]; p < .005), and with post-prandial blood glucose ≤10 mmol/l (180 mg/dl) (14 patients, [12.1%] versus 87 patients [76.3%]; p < .05) significantly increased. There were also significant decreases in body weight (76.3 ± 12.9 kg versus 74.8 ± 12.5 kg; p < .001) and waist circumference (96.1 ± 16.0 cm versus 94.4 ± 14.5 cm; p < .005). Only 4 patients (3.5%) had hypoglycaemia.
Conclusions
Basal–prandial therapy improved glycaemic control in patients with type 2 DM, with a low incidence of hypoglycaemia, and decreased body weight.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
