Probability of Achieving Glycemic Control with Basal Insulin in Patients with Type 2 Diabetes in Real-World Practice in the USA
Probability of Achieving Glycemic Control with Basal Insulin in Patients with Type 2 Diabetes in Real-World Practice in the USA
复制标题
DOI：
10.1007/s13300-018-0413-5
复制
发表时间：
2018-06-01
期刊：
影响因子：
3.8
通讯作者：
McCrimmon, Rory J.
中科院分区：
文献类型：
--
作者：
Blonde, Lawrence;Meneghini, Luigi;McCrimmon, Rory J.
简介：基础胰岛素（BI）在治疗2型糖尿病（T2 D）中起着重要作用，特别是当口服降糖药（OAD）不足以控制血糖时。我们使用IBM（R）Explorys数据库中的电子病历（EMR）数据进行了一项回顾性、观察性研究，以评估美国T2 D患者在开始BI治疗后24个月内实现血糖控制的概率。一个包含6597名T2 D患者的队列，这些患者在OAD后开始BI并且具有至少一个有效的糖化血红蛋白（HbAlc）选择BI开始前90天和BI开始后720天内记录的结果。我们估计了每6个月HbAlc从基线的变化，如果患者在每个季度之前没有实现血糖控制，则达到HbAlc < 7%的季度条件概率（Q），以及在24个月内达到血糖控制的累积概率。在BI开始时平均HbAlc为9.1%，并且在开始后的前6个月内稳健地降低（1.5%），此后没有进一步降低。达到血糖控制的条件概率在第一年迅速下降（Q2为26.6%; Q3为17.6%; Q4为8.6%），然后保持较低水平（
Introduction: Basal insulin (BI) plays an important role in treating type 2 diabetes (T2D), especially when oral antidiabetic (OAD) medications are insufficient for glycemic control. We conducted a retrospective, observational study using electronic medical records (EMR) data from the IBM (R) Explorys database to evaluate the probability of achieving glycemic control over 24 months after BI initiation in patients with T2D in the USA.Methods: A cohort of 6597 patients with T2D who started BI following OAD(s) and had at least one valid glycated hemoglobin (HbAlc) result recorded both within 90 days before and 720 days after BI initiation were selected. We estimated the changes from baseline in HbAlc every 6 months, the quarterly conditional probabilities of reaching HbAlc < 7% if a patient had not achieved glycemic control prior to each quarter (Q), and the cumulative probability of reaching glycemic control over 24 months.Results: Our cohort was representative of patients with T2D who initiated BI from OADs in the USA. The average HbAlc was 9.1% at BI initiation, and decreased robustly (1.5%) in the first 6 months after initiation with no further reductions thereafter. The conditional probability of reaching glycemic control decreased rapidly in the first year (26.6% in Q2; 17.6% in Q3; 8.6% in Q4), and then remained low (