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Diabetes Care:2型糖尿病的血糖控制:CSII vs MDI

2017-05-18 石岩 环球医学

2017年5月,发表在《Diabetes Care》的一项由英国科学家进行的随机对照试验的个体患者数据Meta分析和Meta回归,比较了持续皮下胰岛素输注(CSII)和每日多次胰岛素注射(MDI)的血糖控制。目的:比较2型糖尿病患者在CSII和MDI期间的血糖控制,来确定采用CSII治疗更有效的患者的特质。研究设计方法:选定随机对照试验,比较2型糖尿病人群中CSII vs MDI治疗期间的HbA1

2017年5月,发表在《Diabetes Care》的一项由英国科学家进行的随机对照试验的个体患者数据Meta分析和Meta回归,比较了持续皮下胰岛素输注(CSII)和每日多次胰岛素注射(MDI)的血糖控制。

目的:比较2型糖尿病患者在CSII和MDI期间的血糖控制,来确定采用CSII治疗更有效的患者的特质。

研究设计方法:选定随机对照试验,比较2型糖尿病人群中CSII vs MDI治疗期间的HbA1c。数据来源包括Cochrane database和Ovid Medline数据库。研究人员使用个体患者数据的贝叶斯Meta回归模型探究患者水平的终期HbA1c水平和胰岛素剂量的决定因素,使用两步Meta分析探究整体效果。低血糖症数据不可用。

结果:确定5项实验,287名患者随机接受MDI,303名接受CSII。基线HbA1c是终期HbA1c最好的决定因素:所有实验中HbA1c差异(%)用1.575–(0.216[95%置信区间0.371~0.043]×基线HbA1c)表示,但最大的效果出现在随机化前优化了对照组的研究中。基线胰岛素剂量可最好的预测终期胰岛素剂量:胰岛素剂量差异(单位/千克)=0.1245-(0.382[0.510~0.254]×基线胰岛素剂量)。总体HbA1c差异为-0.40%(-0.86~0.05[-4.4mmol/mol(-9.4~0.6)])。总体胰岛素剂量减少了-0.25单位/千克(-0.31~-0.19)(CSII减少26%)和减少了-24.0单位/天(-30.6~-17.5)。平均体重在两种治疗中没有差异(0.08千克[-0.33~0.48])。

结论:在控制不佳的2型糖尿病人群中,CSII比MDI能获得更好的血糖控制,对胰岛素的需要减少约26%并且没有体重变化。最好的效果发生在那些基线使用最高的胰岛素剂量、最差的控制的患者上。

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    2017-06-17 jyzxjiangqin

    2型糖尿病的血糖控制。

    0

  6. 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    2017-05-27 I come

    学习了谢谢分享

    0

  7. 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    2017-05-21 jyzxjiangqin

    2型糖尿病的血糖控制。

    0

  8. 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    2017-05-19 虈亣靌

    不错的方式,努力学习,刻苦专研,不断总结出来新经验。

    0

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    2017-05-19 189****7206

    学习了,谢谢分享。

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