Clinical predictors of risk of hypoglycaemia during addition and titration of insulin glargine for type 2 diabetes mellitus
Clinical predictors of risk of hypoglycaemia during addition and titration of insulin glargine for type 2 diabetes mellitus
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DOI：
10.1111/dom.12072
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发表时间：
2013-07-01
影响因子：
5.8
通讯作者：
Riddle, M. C.
中科院分区：
文献类型：
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作者：
Karl, D. M.;Gill, J.;Riddle, M. C.
目的基础胰岛素的添加和滴定通常能有效改善2型糖尿病患者的血糖控制，但对低血糖的恐惧仍然是一个障碍。能够预测哪些患者可能处于低血糖的最大风险可能促进个体化治疗和提高安全性。本研究的目的是获得有关临床特征的信息，这些信息可能会预测基础胰岛素开始时低血糖的风险。方法对11项研究中2251名患者的数据进行汇总，这些研究均采用类似的治疗-靶向方法开始使用甘精胰岛素，并用logistic回归模型进行分析。结果参与者平均年龄58岁，糖尿病病程8.9年，体重指数31.0，基线A1c为8.8%。在6个月的治疗期间，他们的平均糖化血红蛋白达到7.1%，最终平均甘精剂量为0.44单位/kg。52%出现症状性低血糖，血糖确诊低血糖（血糖）
Aim Addition and titration of basal insulin is usually effective in improving glycaemic control in type 2 diabetes, but fear of hypoglycaemia remains a barrier. Ability to predict which patients might be at greatest risk of hypoglycaemia might facilitate individualization of treatment and improve safety. The aim of this study was to obtain information about clinical characteristics which might predict risk of hypoglycaemia during initiation of basal insulin. Methods Patient-level data from 2251 participants in 11 studies in which insulin glargine was started and titrated using similar treat-to-target methods was pooled and analysed with logistic regression models. Results Participants had mean age 58years, diabetes duration 8.9years, body mass index 31.0 and baseline A1c 8.8%. They attained mean A1c 7.1% during 6months of treatment with final mean glargine dosage 0.44units/kg. Symptomatic hypoglycaemia occurred in 52%, glucose-confirmed hypoglycaemia (blood glucose