Predicting post one-year durability of glucose-lowering monotherapies in patients with newly-diagnosed type 2 diabetes mellitus - A MASTERMIND precision medicine approach (UKPDS 87).
Predicting post one-year durability of glucose-lowering monotherapies in patients with newly-diagnosed type 2 diabetes mellitus - A MASTERMIND precision medicine approach (UKPDS 87).
复制标题
预测新诊断 2 型糖尿病患者降糖单一疗法一年后的持久性 - MASTERMIND 精准医学方法 (UKPDS 87)。
DOI：
10.1016/j.diabres.2020.108333
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发表时间：
2020
影响因子：
5.1
通讯作者：
Agbaje OF
中科院分区：
文献类型：
--
作者：
Agbaje OF
AimsPredicting可能的持久性降糖治疗的人与2型糖尿病（T2 D）可以帮助通知individualised therapeutic choice.MethodsWe使用的数据从UKPDS患者与新诊断的T2 D随机一线降糖单药治疗氯磺丙脲，格列本脲，基础胰岛素或二甲双胍。在2339名1年HbA 1c值<7.5%（<59 mmol/mol）的参与者中，我们评估了1年特征与至单药治疗失败（HbA 1c ≥ 7.5%或需要二线治疗）时间之间的关系。模型验证采用bootstrap sampling. Resultsfollow是中位数（IQR）11.0（8.0-14.0）年。在中位4.5（3.0-6.6）-3.7（2.6-5.6）-4.2（2.7-6.5）和3.8（2.6 - 5.2）年后，随机分配至氯磺丙脲-格列本脲-基础胰岛素或二甲双胍组的患者中，单药治疗失败的发生率分别为72%-82%-75%和79%。单药治疗失败的时间主要由HbA 1c和BMI值预测，其他风险因素因单药治疗类型而异，氯磺丙脲-格列本脲-基础胰岛素和二甲双胍单药治疗队列的预测值分别为55%-60%-56%和57% ±2.5年。开始传统单一疗法后一年的7.5%。这些信息可用于帮助指导个体患者的贫血管理。
AimsPredicting likely durability of glucose-lowering therapies for people with type 2 diabetes (T2D) could help inform individualised therapeutic choices.MethodsWe used data from UKPDS patients with newly-diagnosed T2D randomised to first-line glucose-lowering monotherapy with chlorpropamide–glibenclamide–basal insulin or metformin. In 2339 participants who achieved one-year HbA1cvalues <7.5% (<59 mmol/mol)–we assessed relationships between one-year characteristics and time to monotherapy-failure (HbA1c≥ 7.5% or requiring second-line therapy). Model validation was performed using bootstrap sampling.ResultsFollow-up was median (IQR) 11.0 (8.0–14.0) years. Monotherapy-failure occurred in 72%–82%–75% and 79% for those randomised to chlorpropamide–glibenclamide–basal insulin or metformin respectively–after median 4.5 (3.0–6.6)–3.7 (2.6–5.6)–4.2 (2.7–6.5) and 3.8 (2.6– 5.2) years. Time-to-monotherapy-failure was predicted primarily by HbA1cand BMI values–with other risk factors varying by type of monotherapy–with predictions to within ±2.5 years for 55%–60%–56% and 57% of the chlorpropamide–glibenclamide–basal insulin and metformin monotherapy cohorts respectively.ConclusionsPost one-year glycaemic durability can be predicted robustly in individuals with newly-diagnosed T2D who achieve HbA1c values< 7.5% one year after commencing traditional monotherapies. Such information could be used to help guide glycaemic management for individual patients.