摘要
目的探讨阿卡波糖联合胰岛素治疗在成人1型糖尿病(T1DM)患者中的使用现状及疗效。方法纳入广东省T1DM转化医学研究项目2011年6月至2014年12月登记的阿卡波糖联合胰岛素(阿卡波糖组)或单用胰岛素(胰岛素组)、年龄≥18岁且病程≥1年的成人T1DM患者,比较阿卡波糖组与胰岛素组入组和1年后的糖化血红蛋白(HbA_(1c))、体重、BMI、腰臀比(WHR)、胰岛素用量和低血糖发生情况。结果共纳入成人T1DM患者717例(阿卡波糖组62例,胰岛素组655例)。入组时,阿卡波糖组起病年龄大于胰岛素组[(31.1±12.3)岁vs(27.4±12.4)岁,P=0.019],两组性别、年龄、病程、体重、BMI、WHR、碳水化合物热占比≥50%的患者比例、每周运动时间≥150 min的患者比例、HbA_(1c)、胰岛素用量、低血糖发生情况及合并血脂异常的患者比例比较差异均无统计学意义(均P>0.05)。随访1年后,阿卡波糖组和胰岛素组的HbA_(1c)均较基线下降(P=0.014,P<0.001),体重和BMI均较基线增加(均P<0.05),而两组的WHR、胰岛素用量和低血糖发生情况与基线比较差异均无统计学意义(均P>0.05)。阿卡波糖组随访1年后的HbA_(1c)、体重、BMI、WHR、胰岛素用量和低血糖发生情况较基线发生的变化与胰岛素组相比差异均无统计学意义(均P>0.05)。结论在T1DM治疗的临床实践中,阿卡波糖在起病年龄稍大的患者中使用更多。胰岛素联用阿卡波糖治疗T1DM不增加低血糖发生,亦未观察到其改善HbA_(1c)、维持体重和减少胰岛素用量的获益。
Objective To describe the current status and efficacy of additional acarbose combined with insulin therapy in adult patients with type 1 diabetes mellitus(T1DM).Methods Adult T1DM patients with acarbose combined with insulin(acarbose group)or insulin alone(insulin group),age≥18 years and disease course≥1 year,who were registered in the T1DM Translational Medicine Research Project of Guangdong Province from June 2011 to December 2014 were enrolled in the study.The hemoglobin A1c(HbA_(1c)),body weight,body mass index(BMI),waist-to-hip ratio(WHR),insulin dosage and hypoglycemia of acarbose group and insulin group after 1 year were compared.Results A total of 717 adult patients with T1DM were included(62 cases in acarbose group and 655 cases in insulin group).At the time of enrollment,the onset age of acarbose group was higher than that of insulin group[(31.1±12.3)years vs(27.4±12.4)years,P=0.019];There were no significant differences in gender,age,course of disease,body weight,BMI,WHR,proportion of carbohydrate heat≥50%,proportion of exercise time≥150 min per week,HbA_(1c),dosage of insulin,occurence of hypoglycemia and proportion of patients with dyslipidemia between the 2 groups(all P>0.05).After 1 year of follow-up,the HbA_(1c)in acarbose and insulin group decreased from baseline(P=0.014,P<0.001),the body weight and BMI increased from baseline(all P<0.05),but WHR,insulin dosage and hypoglycemia occurrence were not statistically significant between the two groups(all P>0.05).After 1 year of follow-up,there were no significant difference in changes of HbA_(1c),body weight,BMI,WHR,insulin dosage and hypoglycemia occurrence in acarbose group compared with insulin group from baseline(all P>0.05).Conclusions In the clinical practice of T1DM treatment,acarbose is used more frequently in patients with a slightly older age of onset.Treatment of T1DM with insulin combined with acarbose did not increase the incidence of hypoglycemia,and no benefit was observed in improving HbA_(1c),maintaining body weight,and redu
作者
邱丽玲
吕婧
梁干雄
叶凯云
杨黛稚
邓洪容
凌萍
严晋华
Qiu Liling;Lyu Jing;Liang Ganxiong;Ye Kaiyun;Yang Daizhi;Deng Hongrong;Ling Ping;Yan Jinhua(Department of Endocrinology,Zhongshan City People′s Hospital,Zhongshan Hospital of Sun Yat-sen University,Zhongshan 528400,China;Department of Endocrinology and Metabolism,Guangdong Provincial Key Laboratory of Diabetology,The Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)
出处
《中国医师杂志》
CAS
2023年第3期325-329,共5页
Journal of Chinese Physician
基金
国家重点研发计划项目(2017YFC1309602,2017YFC1309603)
广州市科技计划项目(202102010154)。
