速效胰岛素类似物的优势比较.pptVIP

* 这是一个将诺和锐、人胰岛素和赖脯胰岛素在泵中使用结合在一起比较的研究。研究的设计是： 146 名患者， T1DM， 病程 2–25年 7% ? HbA1c ? 9%, 以前应用 CSII 3 个月或以上 随机，平行分组，干预 16 周 人胰岛素冲击量餐前30分钟给与，诺和锐?和赖铺胰岛素餐时给与 在诺和锐组中，晚餐后血糖较其它组显著降低，早餐后及午餐后与赖脯胰岛素组相比差别不大。 请注意如有代表问到2am赖脯胰岛素组较诺和锐组血糖较高，不易发生低血糖风险，需提醒诺和锐与赖脯胰岛素组的比较没有统计学差异，但两者对比人胰岛素组均不易发生低血糖，且有统计学差异。 Reference Bode B, Weinstein R, Bell D, McGill J, Nadeau D, Raskin P, Davidson J, Henry R, Huang WC, Reinhardt RR. Comparison of insulin aspart with buffered regular insulin and insulin lispro in continuous subcutaneous insulin infusion: a randomized study in type 1 diabetes. Diabetes Care 2002;25:439–44. * 单中心，随机对照，开放，为期3天的交叉研究 17名年龄≥18岁，BMI 26-28 kg/m2，HbA1c≤8.0%，目前已应用诺和锐或优泌乐超过3个月的1型糖尿病患者 排除标准：任何其他伴随疾病、频发严重低血糖、出现过无意识低血糖、妊娠或哺乳期妇女 mean age 40.4 ± 6.5 years; glycosylated hemoglobin 7.5 ±0.5%; duration of diabetes 19.0 ± 11.3 years For each insulin treatment, the following periods were extracted from CGMS data and considered for analysis: the two consecutive 4-h postprandial periods for a total of 8 h for analysis of daytime glucose variability; and the two consecutive 2-h postprandial periods for analysis of postprandial glucose variability. We used the absolute glucose of measured postprandial glucose (0–120 min) as an indicator of glucose stability around the starting glucose level. * 美国的146位1型糖尿病患者在用CSII治疗3个月后做的临床观察 诺和锐的夜间低血糖的事件 显著低于人胰岛素，没有发生夜间低血糖事件的患者在诺和锐组占41%，在Lispro 组占25% Rates of confirmed (BG 50 mg/dl) hypoglycaemia were similar with all three treatments; Rates of all reported episodes regardless of BG value were lower for insulin aspart. Rates of nocturnal hypoglycaemia were significantly lower with IAsp compared with HI. No nocturnal episodes in 41% of people using insulin aspart vs. 25% using insulin lispro. This 16-week, randomised, parallel-group study compared IAsp, ILisp and HI in pump therapy, in 146 patients (USA), duration diabetes 2–25 years, 7% ? HbA1c ? 9%, who had previously used CSII for 3 months. Patients randomised in 2:2:1 ratio (insulin aspart:human ins