Reduced frequency of severs hypoglycemia and coma in well-controlled IDDM patients treated with insulin lispro
Reduced frequency of severs hypoglycemia and coma in well-controlled IDDM patients treated with insulin lispro
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DOI：
10.2337/diacare.20.12.1827
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发表时间：
1997-12-01
期刊：
影响因子：
16.2
通讯作者：
Anderson, JH
中科院分区：
文献类型：
--
作者：
Holleman, F;Schmitt, H;Anderson, JH
目的：几项研究表明，与常规胰岛素相比，在多次注射治疗中使用短效胰岛素类似物胰岛素利斯普罗可降低低血糖的风险。这种效果在控制良好的患者中可能更为明显，因为IDDM的强化治疗增加了严重低血糖事件的发生率。本研究评估胰岛素利斯普罗对控制良好的IDDM患者血糖控制和低血糖率的影响。研究设计和方法：这是一项开放、随机、为期6个月的交叉研究，纳入199例IDDM患者。通过HbA（1c）、家庭血糖测量以及低血糖事件的发生率和时间来评估血糖控制。在螺柱的末端！！患者完成了一份关于治疗相关生活质量的评估表格。结果：在整个研究过程中，HbA（1c）保持在7.3%的水平。与常规胰岛素相比，胰岛素lispro组与膳食相关的葡萄糖漂移显著降低（平均-0.8 +/- 1.7 vs. 1.1 +/- 1.6 mmol/l, P < 0.001），日内变异性也是如此（M值27.7 +/- 19.7 vs. 30.2 +/- 23.1, P = 0.007）。严重低血糖事件发生率（58比36，P = 0.037）包括昏迷发生率（16比3，P = 0.004）胰岛素利斯普罗组显著低于常规胰岛素组。患者认为胰岛素lispro增加了生活方式的灵活性和自由度。结论：在控制良好的IDDM患者中，胰岛素利斯普罗与较低的严重低血糖和昏迷风险相关。
OBJECTIVE - Several studies have suggested that use of the short-acting insulin analog, insulin lispro, in multiple injection therapy may reduce the risk of hypoglycemia in comparison with regular insulin. This effect might be more pronounced in well-controlled patients, since intensive treatment of IDDM increases the rate of severe hypoglycemic events. This study evaluated the effects of insulin lispro on glycemic control and hypoglycemia rates in well-controlled IDDM patients.RESEARCH DESIGN AND METHODS - This was an open, randomized, 6-month crossover study of 199 IDDM patients. Glycemic control was evaluated by HbA(1c), home blood glucose measurements, and rate and timing of hypoglycemic events. At the end of the stud!! patients completed an evaluation form regarding therapy related quality of life.RESULTS - HbA(1c) remained constant at similar to 7.3% throughout the study. Meal-related glucose excursions were significantly lower with insulin lispro compared with regular insulin (mean -0.8 +/- 1.7 vs. 1.1 +/- 1.6 mmol/l, P < 0.001), as was the within-day variability (M value 27.7 +/- 19.7 vs. 30.2 +/- 23.1, P = 0.007). The incidence of severe hypoglycemic events (58 vs. 36, P = 0.037) including coma (16 vs. 3, P = 0.004) was significantly lower with insulin lispro than with regular insulin. Patients felt that insulin lispro increased flexibility and freedom of lifestyle.CONCLUSIONS - In well-controlled IDDM patients, insulin lispro is associated with a lower risk of severe hypoglycemia and coma.