讨论组起始基础胰岛素方案探讨.ppt

第二组：起始基础胰岛素0+1方案探讨 第二组讨论问题：起始基础胰岛素0+1方案探讨 1.起始基础胰岛素0+1治疗方案适合哪些人群？ 2.起始基础胰岛素0+1治疗方案的可行性和必要性有哪些？ 3.确保0+1治疗方案成功的因素有哪些？ 糖尿病治疗随时代的演变而更新－需要个性化治疗 不同饮食模式最高餐后血糖出现时间不同 二甲双胍＋磺脲类治疗失败后，加用甘精胰岛素较加用其他OAD，安全性更好 加用甘精胰岛素组的不良事件、中止治疗发生率显著低于加用OAD组；体重增加幅度显著低于加用OAD组 总结 来得时“0+1”的治疗方案较继续调整OAD、NPH及预混胰 岛素 血糖达标率更高的基础上，低血糖发生更少 更加简单、方便、安全，更能满足个体化治疗的需求 Description Schreiber et al carried out an observational study to investigate the long-term efficacy and safety of adding Insulin Glargine to OAD treatment in patients with T2DM in everyday practice This was a 9-month, open-label, observational study, with optional 20- and 32-month extension phases, in which add-on Insulin Glargine therapy was initiated in 12,216 patients with T2DM inadequately controlled on OADs This study found that addition of Insulin Glargine to OAD therapy led to reductions in mean HbA1c (?1.5%) and FBG (?69 mg/dL [3.8 mmol/L]) levels after 3 months, which were maintained after 9 months (HbA1c, ?1.7%; FBG ?71 mg/dL [3.9 mmol/L])1 and at 32 months (HbA1c, –1.6%; FBG, –71.8 mg/dL [–4.0 mmol/L])2 A trend of decreasing BMI values was observed in the overall study population, from a mean of 29.0 ± 4.7 kg/m2 at baseline to 28.7 ± 4.5 kg/m2 after 3 months and 28.5 ± 4.8 kg/m2 after 9 months1 The extension phases showed an overall decrease in patient BMI from 29.0 ± 4.7 to 28.6 ± 4.7 kg/m2 at 9 months, 28.7 ± 4.7 kg/m2 at 20 months (?0.4 kg/m2 after 20 months)1 and 28.6 ± 4.7 kg/m2 at 32 months (?0.3 ± 3.2 kg/m2 after 32 months)2 In everyday practice, patients with T2DM who are inadequately controlled on OADs benefit from add-on basal insulin treatment with Insulin Glargine, as they demonstrate improved glycaemic control without weight gain Study summary Aim: To analyze the effects of long-term, once-daily Insulin Glargine plus OAD therapy on glycaemic control Study design: 9-month, open-label, uncontrolled, multicentre, observational study with a 32-month extension Outcomes Primary: Final HbA1c Secondary: FPG, dail