| アブストラクト | AIM: To investigate the effectiveness of premixed insulin for achieving glycaemic outcomes in clinical practice in the UK. MATERIALS AND METHODS: Electronic medical record data from The Health Improvement Network database were captured for adults with type 2 diabetes (T2D) uncontrolled (HbA1c >/=9%) on two or more oral antihyperglycaemic drugs (OADs) initiating premixed insulin. Effectiveness of premixed insulin was assessed by the probability and incidence of achieving glycaemic outcomes (target HbA1c <7.5% [<58 mmol/mol] and a >/=1% or >/=2% HbA1c reduction) over 24 months. RESULTS: Data from 974 participants (mean age 62 years; 56% male; 52% obese or extremely obese; mean HbA1c 11.3% [100 mmol/mol]; hypertension 64%, dyslipidaemia 23% and nephropathy 21%) were analysed. The probability of achieving HbA1c <7.5% was highest during months 3-6 (18.2%), while the cumulative probability of achieving this target plateaued between months 15-24 (15.7%-16.0%). Incidence of achieving all glycaemic outcomes plateaued after 12 months and differed by baseline HbA1c, but not OAD use. Factors affecting some glycaemic outcomes included a body mass index >40 kg/m(2) and co-morbidities including nephropathy and stroke. CONCLUSIONS: In people with uncontrolled T2D (HbA1c >/=9%), glycaemic outcome achievement on premixed insulin was low at 6 months with little additional clinical benefit beyond 12 months, suggesting a high unmet need for early, timely treatment changes with more effective, simpler therapies. |
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| ジャーナル名 | Diabetes, obesity & metabolism |
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| 投稿日 | 2020/12/16 |
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| 投稿者 | Jude, Edward B; Trescoli, Carlos; Emral, Rifat; Ali, Amar; Lubwama, Robert; Palmer, Karen; Shaunik, Alka; Nanda, Nithya; Raskin, Philip; Gomez-Peralta, Fernando |
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| 組織名 | Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, UK.;Hospital Universitario de La Ribera, Alzira, Spain.;Department of Endocrinology and Metabolic Diseases, Faculty of Medicine, Ankara;University, Ankara, Turkey.;Oakenhurst Medical Practice, Blackburn, UK.;Sanofi, Bridgewater, New Jersey.;Sanofi, Reading, UK.;Farnham Road Practice, Slough, UK.;Department of Medicine, University of Texas Southwestern Medical Center, Dallas,;Texas.;Endocrinology and Nutrition Unit, Segovia General Hospital, Segovia, Spain. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/33319424/ |
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