Actual usage and clinical effectiveness of insulin preparations in patients with type 1 diabetes mellitus in Japan:: CoDiC®-based analysis of clinical data obtained at multiple institutions (JDDM 3)
Actual usage and clinical effectiveness of insulin preparations in patients with type 1 diabetes mellitus in Japan:: CoDiC®-based analysis of clinical data obtained at multiple institutions (JDDM 3)
复制标题
DOI：
10.1016/j.diabres.2005.03.040
复制
发表时间：
2006-06-01
影响因子：
5.1
通讯作者：
Kobayashi, Masashi
中科院分区：
文献类型：
--
作者：
Kanatsuka, Azuma;Kawai, Koichi;Kobayashi, Masashi
为了阐明胰岛素制剂的实际使用及其对日本I型糖尿病患者血糖控制的有效性，我们分析了通过CoDiC（（R））收集的临床数据，CoDiC是一种用于糖尿病数据收集和管理的电子系统，在28个研究所。2003年6月在CoDiC注册的18，470名糖尿病患者中，12，279名患者正在接受胰岛素制剂和/或口服降糖药治疗，其中861名患者患有I型糖尿病，11，418名患者患有2型糖尿病。对I型糖尿病患者进行了三次分析调查。研究一：2002年关于治疗的横断面调查。613例患者接受了强化常规胰岛素治疗（ICT）。接受速效胰岛素类似物（RA）治疗的患者数量大于接受常规胰岛素（R）治疗的患者数量。ICT组血清CPR低于常规胰岛素治疗组（CT）。研究II：基于2001年和2002年输入的数据，对胰岛素制剂实际使用和临床有效性变化的调查。ICT患者使用RA胰岛素的数量明显增加。研究III：分析参与者从第一次咨询开始的18个月研究期间的临床病程。胰岛素的剂量在这段时间内增加。平均HbA 1c水平急剧下降，在研究的前9个月达到7.5%，然后在研究期间的剩余时间内保持在7.5%至8%的范围内。总之，ICT是积极进行和RA胰岛素类似物被广泛用于1型糖尿病患者在日本。餐后血清CPR低于0.5 ng/ml的1型糖尿病患者应采用基础-餐时胰岛素治疗。目前可用的胰岛素制剂难以在1型糖尿病患者中获得理想的血糖控制。(c)2006爱思唯尔爱尔兰有限公司保留所有权利。
To clarify the actual usage of insulin preparations and their effectiveness on glycaemic control in patients with Type I diabetes mellitus in Japan, we analyzed clinical data collected via CoDiC((R)), an electronic system for diabetes data collection and management, at 28 institutes. Of 18,470 diabetic patients registered with CoDiC((R)) in June, 2003, 12,279 patients were being treated with insulin preparations and/or oral hypoglycemic agents, with 861 of these patients having Type I diabetes mellitus and 11,418 patients having Type 2 diabetes. Three analytical surveys were carried out with the Type I diabetes patients. Study I: Cross-sectional survey on the treatment in 2002. Six hundred and thirteen patients received intensive conventional insulin treatment (ICT). The number of patients receiving rapid-acting insulin analogue (RA) was greater than that of patients receiving regular insulin (R). Serum CPR was lower in the patients with ICT than in the patients with conventional insulin treatment (CT). Study II: Survey on the changes in the actual usage and clinical effectiveness of insulin preparations, based on the data input in 2001 and 2002. The number of patients with ICT using RA insulin markedly increased. Study III: Analysis of the participants' clinical course over the 18-month period of the study from the time of first consultation. The dose of insulin increased during the term. The average HbA1c level fell drastically and reached to 7.5% over the first 9 months of the study and then remained between a range of 7.5% and 8% for the rest of the study period. In conclusion, ICT is actively performed and the RA insulin analogues are widely used in Type 1 diabetic patients in Japan. Basal-bolus therapy should be used to treat Type 1 diabetic patients with postprandial serum CPR of less than 0.5 ng/ml. It is difficult to obtain the ideal glycaemic control in Type 1 diabetic patients with the currently available insulin preparations. (c) 2006 Elsevier Ireland Ltd. All rights reserved.