Magnitude of Glycemic Improvement in Patients with Type 2 Diabetes Treated with Basal Insulin: Subgroup Analyses from the MOBILE Study.
Magnitude of Glycemic Improvement in Patients with Type 2 Diabetes Treated with Basal Insulin: Subgroup Analyses from the MOBILE Study.
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DOI：
10.1089/dia.2021.0489
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发表时间：
2022-05
影响因子：
5.4
通讯作者：
中科院分区：
文献类型：
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确定基线血糖控制较差的2型糖尿病患者使用基础胰岛素而不使用膳食胰岛素是否从实时连续血糖监测（CGM）中获益最大。我们对MOBILE研究进行了事后分析，这是一项多中心试验，研究了CGM与血糖仪自我监测（BGM）对接受基础胰岛素治疗而不使用膳食胰岛素治疗的2型糖尿病患者的影响。参与者根据基线血红蛋白A1c （HbA1c）和基线时间范围70-180 mg/dL （TIR）分为亚组。计算每个亚组内TIR与基线的变化。在基于基线HbA1c的亚组中，与BGM组相比，基线HbA1c≥8.5%时，CGM组的TIR增加了14%，基线HbA1c≥9.0%时增加了14%，基线HbA1c≥9.5%时增加了22%，基线HbA1c≥10.0%时增加了32%（相互作用的p值= 0.27）。在HbA1c值较高的参与者中，与BGM相比，CGM患者血糖浓度为250 mg/dL的时间显著降低（相互作用P = 0.004）。基于基线TIR的亚组结果与基于基线HbA1c的亚组结果相似。虽然在基础胰岛素治疗的2型糖尿病患者中，CGM对TIR的益处在基线血糖控制范围内都很明显，但CGM对基线血糖控制最差的患者影响最大，特别是在HbA1c≥10%的患者中。临床试验注册号：NCT03566693。
To determine if type 2 diabetes patients using basal insulin without prandial insulin with worse glycemic control at baseline would have the greatest benefit from using real-time continuous glucose monitoring (CGM). We conducted a post hoc analysis of the MOBILE Study, a multicenter trial examining the impact of CGM versus self-monitoring with a blood glucose meter (BGM) in patients with type 2 diabetes treated with basal insulin without prandial insulin. Participants were divided into subgroups based on baseline hemoglobin A1c (HbA1c) and baseline time-in-range 70–180 mg/dL (TIR). Change in TIR from baseline was calculated within each subgroup. In subgroups based on baseline HbA1c, compared with the BGM group, the CGM group had 14% greater increase in TIR for participants with baseline HbA1c ≥8.5%, 14% greater increase for baseline HbA1c ≥9.0%, 22% greater increase for baseline HbA1c ≥9.5%, and 32% greater increase for baseline HbA1c ≥10.0% (P-value for interaction = 0.27). The time spent with glucose >250 mg/dL was significantly lower with CGM compared with BGM among participants with higher HbA1c values (P for interaction = 0.004). Results in subgroups based on baseline TIR paralleled the results in subgroups based on baseline HbA1c. While the benefit of CGM on TIR among patients with type 2 diabetes treated with basal insulin is apparent across the range of baseline glycemic control, the greatest impact of CGM is in those with the worst baseline glycemic control, particularly among those with HbA1c ≥10%. Clinical Trial Registration number: NCT03566693.
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影响因子：
168.9
作者：
Reznik, Yves;Cohen, Ohad;Lee, Scott W.
通讯作者：
Lee, Scott W.
DOI：
10.1111/dom.14238
发表时间：
2021-03
期刊：
Diabetes, obesity & metabolism
影响因子：
--
作者：
Peters A;Cohen N;Calhoun P;Ruedy KJ;Beck RW;Martens TW;Bao S;Njeru NM;Beck SE;Price DA
通讯作者：
Price DA
影响因子：
120.7
作者：
Martens, Thomas;Beck, Roy W.;Group, Mobile Study
通讯作者：
Group, Mobile Study
影响因子：
5.1
作者：
Yoo, H. J.;An, H. G.;Baik, S. H.
通讯作者：
Baik, S. H.
影响因子：
120.7
作者：
Lind, Marcus;Polonsky, William;Hellman, Jarl
通讯作者：
Hellman, Jarl