Comparison of continual insulin or secretagogue treatment in type 2 diabetic patients with alternate insulin-secretagogue administration
Comparison of continual insulin or secretagogue treatment in type 2 diabetic patients with alternate insulin-secretagogue administration
复制标题
2 型糖尿病患者持续胰岛素或促分泌剂治疗与交替胰岛素-促分泌剂给药的比较。
DOI：
10.1016/j.diabres.2009.01.020
复制
发表时间：
2009-05-01
影响因子：
5.1
通讯作者：
Wu, Guoting
中科院分区：
文献类型：
--
作者：
Li, Hong;Li, Wenjun;Wu, Guoting
背景：比较三种治疗方式对胰岛功能较好的2型糖尿病患者的依从性和疗效。方法：这项为期38个月的开放、随机、前瞻性研究纳入了536名受试者（HbA1c 9.4 +/- 0.8%）。将患者分为持续注射胰岛素组(I)、持续使用促分泌剂组(S)和交替使用2个月胰岛素+ 4个月促分泌剂组(A)。在基线和每三个月测量一次HbA1c，并进行标准面包粉测试（100 g）。结果：I组和A组的HbA1c控制均优于S组（6.9 +/- 0.3%,6.8 +/- 0.3% vs. 7.6 +/- 0.5%）。A组低血糖发生率远低于1组（0.8次/患者/月vs. 2.4次/患者/月），体重增加较少（1.6 kg vs. 2.8 kg/患者/年）。从标准面包粉试验来看，A组患者的2-h c肽增量最大。所有被试的调查显示，考虑到方便和有效，大多数人都欢迎替代策略。结论：胰岛素促分泌剂交替治疗可有效降低HbA1c，改善胰岛功能，降低低血糖和体重增加的风险，依从性好。2009爱思唯尔爱尔兰有限公司版权所有。
Background: To compare the compliance and efficacy among three treatment modalities in patients of type 2 diabetes with fairly good islet function.Methods: This 38-month open, randomized, prospective study enrolled 536 subjects (HbA1c 9.4 +/- 0.8%). Patients were divided into three groups including continual insulin injection (I), continual secretagogue administration (S) and alternation of two-month insulin injection and four-month secretagogue treatment (A). At baseline and every three months, HbA1c was measured and a standard bread meal test (100 g) was performed.Results: HbA1c were better controlled in both groups I and A than in S (6.9 +/- 0.3%, 6.8 +/- 0.3% vs. 7.6 +/- 0.5%). Hypoglycemia incidence was much lower in group A than that in 1 (0.8 times/patient/month vs. 2.4 times/patient/month) also with less weight gain (1.6 kg vs. 2.8 kg/patient/year). From the standard bread meal test, patients in group A got the greatest increment of 2-h C-peptide. Inquiry from all subjects showed that alternate strategy was welcomed by most of them considering for convenience and efficacy.Conclusions: Alternate insulin-secretagogue treatment can effectively reduce HbA1c and help to improve islet function with reduced risk of hypoglycemia and weight gain under good compliance. (C) 2009 Elsevier Ireland Ltd. All rights reserved.