Effects of Switching from Insulin Glargine or Detemir to Insulin Degludec in Patients with Type 1 Diabetes Mellitus
Effects of Switching from Insulin Glargine or Detemir to Insulin Degludec in Patients with Type 1 Diabetes Mellitus
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DOI：
10.1007/s13300-013-0048-5
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发表时间：
2013-12-01
期刊：
影响因子：
3.8
通讯作者：
Namba, Mitsuyoshi
中科院分区：
文献类型：
--
作者：
Kusunoki, Yoshiki;Katsuno, Tomoyuki;Namba, Mitsuyoshi
简介：德谷胰岛素是一种新型超长效基础胰岛素。本研究的目的是分析1型糖尿病（T1 DM）基础-餐时胰岛素治疗中基础胰岛素从甘精胰岛素或地特胰岛素转换为德谷胰岛素时基础胰岛素剂量和血糖谱的变化。患者在甘精胰岛素或地特胰岛素转换为德谷胰岛素之前和之后接受了动态血糖监测。10例接受甘精胰岛素或地特胰岛素每日两次治疗的患者转换为德谷胰岛素，剂量为既往胰岛素剂量的80-90%。其余6例接受甘精胰岛素每日一次治疗的患者转换为德谷胰岛素，未下调剂量。每日胰岛素剂量和糖化血红蛋白（HbA 1c）的变化也检查了12周后转换为德谷胰岛素。结果：在从每日两次基础胰岛素转换的患者中，血糖谱转换前后无显著差异。在每日一次组中，血糖水平在转换为德谷治疗后显示出下降趋势。在研究期间，每日两次组的每日胰岛素总剂量（TDD）和每日基础胰岛素总剂量（TBD）显著降低，每日一次组的TDD和TBD在转换为德谷后显示出降低趋势。在两组中，HbA 1c的变化没有显着different.Conclusion：这是可能实现类似的血糖控制与每日一次注射和较低剂量的德谷胰岛素的T1 DM患者谁已经与甘精胰岛素或地特胰岛素治疗。
Introduction: Insulin degludec is a new, ultralong-acting basal insulin. The aim of this study was to analyze the changes of basal insulin dose and blood glucose profile in basal-bolus therapy of type 1 diabetes mellitus (T1DM) at the switching of basal insulin from insulin glargine or detemir to insulin degludec.Methods: Sixteen patients with T1DM were enrolled. The patients underwent continuous glucose monitoring before and after the switching of insulin glargine or detemir to degludec. Ten patients treated with insulin glargine or detemir twice daily, were switched to insulin degludec with 80-90% of the prior insulin dose. The remaining six patients treated with insulin glargine once daily, were switched to insulin degludec without down titration. The changes of daily insulin dose and glycated hemoglobin (HbA1c) were also examined for 12 weeks after switching to insulin degludec.Results: In the patients switched from twice-daily basal insulin, no significant difference was found between before and after switching in the blood glucose profile. In the once-daily group, blood glucose levels showed a tendency to decrease after switching to the degludec treatment. During the study period, total daily insulin dose (TDD) and total daily basal insulin dose (TBD) decreased significantly in the twice-daily group, and TDD and TBD showed a tendency to decrease after switching to degludec in the once-daily group. In both groups, the changes of HbA1c were not significantly different.Conclusion: It is possible to achieve similar glycemic control with once-daily injection and lower doses of insulin degludec in patients with T1DM who have been treated with insulin glargine or detemir.