温故知新-量体裁衣.pptVIP

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2019-02-25 发布于广东
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温故知新-量体裁衣.ppt

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* * * * * * As previously noted, the risk of hypoglycaemia and fear of it impacts on the level of glycaemic control that physicians and patients can aim for, and hence affects a patients prognosis. The DCCT research group (ref on slide) showed an inverse relationship between glycated haemoglobin (HbA1c) and risk of hypoglycaemia. * * * TITRATE研究结果显示，空腹血糖控制目标不同的两组患者，随着基础胰岛素剂量的不断优化，空腹血糖持续改善，HbA1c也显著降低。 * 临床研究也显示地特胰岛素更加严格的血糖控制目标并没有增加低血糖风险，无论全部低血糖还是夜间低血糖在两组之间没有统计学差异。 * In this study, 17,374 patients (53% male) were included. Mean pre-insulin values (±SD) were: age 62?±?12?years; body mass index 29.3?±?5.4?kg/m2 ; diabetes duration 10?±?7?years; HbA1c 8.9?±?1.6 %. During the study, 27 patients experienced serious adverse drug reactions, severe hypoglycaemic events or both, and there were 31 episodes of severe hypoglycaemia in 21 patients. After 24?weeks, HbA1c was 7.5?±?1.2 % (change of -1.3%; p0.001) and mean weight change was -0.6?kg (95% CI -0.7; -0.5?kg; p0.001). Daily insulin dose increased from 13?±?6 U (0.16?±?0.09 U/kg) to 22?±?16 U (0.27?±?0.17U/kg) by 24?weeks. Multivariate regression analysis identified several independent demographic and treatment predictors of end of study HbA1c. 1. Khunti et al. Diab Obes Metab 2012;14:1129–362. Caputo et al. Endocr Pract 2013;19:462–70 * A 24-week observational, non-interventional study in 66,726 people with type 2 diabetes starting biphasic insulin aspart, insulin detemir, or insulin aspart in routine clinical practice. Primary endpoint: the number of serious adverse drug reactions, including major hypoglycaemia from baseline to end of trial Secondary endpoints: other clinical safety and effectiveness parameters People treated with any kind of diabetes therapy other than biphasic insulin aspart 30, insulin detemir, or insulin aspart (alone or in combination) were eligible for the study. Selection of participants and the choice of insulin regimen was at the discretion of the physician. People enroled were divid