Diabetes Care：2型糖尿病胰岛素治疗体重增加的预测因素

2014-05-31 MedSci MedSci原创

据一项最新研究报告，HbA1c、BMI和胰岛素剂量可帮助预测哪些2型糖尿病患者在启动胰岛素治疗后会出现体重增加。该研究5月14日在线发表于《糖尿病护理》杂志。（Diabetes Care 2014 May 13;）2型糖尿病患者在启动胰岛素治疗后常会出现适度的体重增加，明确相关的风险因素有助于制定特定治疗策略以防止体重增加。法国流行病学和人口健康INSERM研究中心的Beverly Balkau博

据一项最新研究报告，HbA1c、BMI和胰岛素剂量可帮助预测哪些2型糖尿病患者在启动胰岛素治疗后会出现体重增加。该研究5月14日在线发表于《糖尿病护理》杂志。（Diabetes Care 2014 May 13;）

2型糖尿病患者在启动胰岛素治疗后常会出现适度的体重增加，明确相关的风险因素有助于制定特定治疗策略以防止体重增加。

法国流行病学和人口健康INSERM研究中心的Beverly Balkau博士及其同事采用CREDIT研究中来自12个国家314个中心共计2179例患者数据来评估胰岛素治疗1年后的体重变化情况及相关风险预测因素。

结果显示，在接受胰岛素治疗1年后，所有患者体重平均增加1.78kg（中位数，2.0kg），其中24%的患者体重增加≥5kg。与体重增加相关的基线因素包括BMI、HbA1c、胰岛素方案、胰岛素剂量、其他降糖药物的使用和高血压。

经多变量模型分析，胰岛素治疗前HbA1c水平较高和BMI较低是治疗后体重增加的独立预测因素。基线HbA1c为8.0%的患者比7.0%的患者体重多增加0.5kg；相反，BMI每增加4.0kg/m2，体重少增加0.5kg。

胰岛素治疗前和治疗后1年的胰岛素使用剂量较高也与体重增加显著相关。然而，1年后的HbA1c水平、HbA1c变化幅度和胰岛素治疗方案均与体重增加无关，不能作为预测因素。

研究人员表示，这些结果向临床医生证实，相比轻度肥胖患者，对重度肥胖患者启动胰岛素治疗并无额外的体重增加风险。尽管生活方式干预在常规治疗中能减少体重增加，但对有些使用胰岛素治疗的患者似乎无效。

原始出处：

Balkau B, Home PD, Vincent M, Marre M, Freemantle N.Factors Associated With Weight Gain in People With Type 2 Diabetes Starting on Insulin.Diabetes Care. 2014 May 13.

van Nielen M, Feskens EJ, Mensink M, Sluijs I, Molina E, Amiano P, Ardanaz E, Balkau B, Beulens J, Boeing H, Clavel-Chapelon F, Fagherazzi G, Franks P, Halkjaer J, Huerta JM, Katzke V, Key T, Khaw KT, Krogh V, Kühn T, Menéndez V, Nilsson P, Overvad K, Palli D, Panico S, Rolandsson O, Romieu I, Sacerdote C, Sánchez MJ, Schulze M, Spijkerman A, Tjonneland A, Tumino R, van der A D, Würtz A, Zamora-Ros R, Langenberg C, Sharp S, Forouhi N, Riboli E, Wareham N; for the InterAct Consortium.Dietary Protein Intake and Incidence of Type 2 Diabetes in Europe: The EPIC-INTERACT Case-Cohort Study. Diabetes Care. 2014 Apr 10.

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2015-04-11 x35042875

国真实妊娠糖尿病患病率应该在这两种方案得到的患病率之间

151 0
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2014-11-01 baoya

#胰岛#

67 0
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2015-02-19 智智灵药

#BET#

78 0
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2015-04-04 ms9608593228839890

#DIA#

56 0
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2014-05-31 木头人513

#Diabetes#

73 0
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2014-06-02 朱睿睿

#预测因素#

72 0
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2014-06-02 839640778

#体重增加#

65 0
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2014-06-02 zjshifan_98647309

#胰岛素治疗#

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Diabetes Care：2型糖尿病胰岛素治疗体重增加的预测因素

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