Clinical outcomes after insulin initiation in patients with type 2 diabetes: 6-month data from the INSTIGATE observational study in five European countries
Clinical outcomes after insulin initiation in patients with type 2 diabetes: 6-month data from the INSTIGATE observational study in five European countries
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DOI：
10.1185/03007995.2011.555755
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发表时间：
2011-05-01
影响因子：
2.3
通讯作者：
Simpson, Alexander
中科院分区：
文献类型：
--
作者：
Liebl, Andreas;Jones, Stephen;Simpson, Alexander
探讨胰岛素治疗方案及影响2型糖尿病患者胰岛素治疗后6个月血糖控制的因素。在五个欧洲国家进行的一项前瞻性、观察性、开放标签研究中，收集了需要胰岛素起始治疗作为常规治疗一部分的患者信息。采用单因素和多元回归分析研究与6个月时HbA1c达到相关的因素。基线时所有患者的平均HbA1c为9.6 +/-+/- 1.8%%。仅长效/中间体胰岛素最常在法国和西班牙开始使用，而长效/中间体或预混合制剂则在希腊和英国开始使用。这与这些国家使用的指南是一致的，这些国家6个月时的胰岛素治疗方案几乎没有变化。在德国，仅在基线时使用短效胰岛素，在6个月时转向基础/大剂量方案，这反映了德国当地的胰岛素启动指南。平均HbA1c降低在德国最大（- 2.3%%），这是唯一一个在6个月时达到平均< 7%的国家。在所有国家，6个月时达到的HbA1c与基线HbA1c相关。BMI、糖尿病持续时间、胰岛素治疗方案、胰岛素剂量和口服抗糖尿病药物数量等因素对HbA1c的影响在各国之间存在差异。这些因素的可解释变异性在5.6%到22.9%之间。各国胰岛素治疗方案存在差异，这似乎反映了所使用的指南和治疗方案。
To examine insulin regimens and factors that affect glycaemic control at 6 months after initiation of insulin therapy in patients with type 2 diabetes mellitus.Information on patients requiring insulin initiation as part of usual care was collected in a prospective, observational, open-label study in five European countries. Univariate and multiple regression analyses were used to investigate factors associated with HbA1c achieved at 6 months.Mean HbA1c for all patients at baseline was 9.6 +/-+/- 1.8%%. Long/intermediate-acting insulin only was most commonly initiated in France and Spain, while long/intermediate or pre-mixed formulations were initiated in Greece and UK. This was consistent with guidelines used in those countries and there was little change in insulin regimen at 6 months in these countries. In Germany, short-acting insulin only was favoured at baseline and there was a shift towards basal/bolus regimens at 6 months, which reflected the local guidelines for insulin initiation in Germany. Mean HbA1c reduction was greatest in Germany (--2.3%%), which was the only country to achieve a mean of < 7%% at 6 months. In all countries, HbA1c achieved at 6 months was associated with baseline HbA1c. Differences between countries were seen for influence of factors such as BMI, duration of diabetes, insulin regimen, insulin dose and number of oral anti-diabetes drugs on HbA1c achieved. Explained variability for the factors ranged from 5.6%% to 22.9%%.Differences in insulin regimen were observed between countries, and appeared to reflect the guidelines and treatment regimens used.