Open Access在短病程2型糖尿病患者的治疗方案中增加基础胰岛素对糖尿病视网膜病变的影响:一项1年随机平行对照临床研究
Author(s) -
Mu PanWei,
Tang XiXiang,
Tan Ying,
Wang YiNa,
Lin Shuo,
Wang ManMan,
Shu Jiong,
Wang Jing,
Zhang YongJun,
Liang Hua,
Lin BaiRun,
Cai MengYin,
Chen YanMing
Publication year - 2019
Publication title -
journal of diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.949
H-Index - 43
eISSN - 1753-0407
pISSN - 1753-0393
DOI - 10.1111/1753-0407.12928
Subject(s) - medicine , glycemic , diabetic retinopathy , diabetes mellitus , insulin , basal (medicine) , retinopathy , basal insulin , randomized controlled trial , gastroenterology , endocrinology , type 2 diabetes
Background In this study, we compared the effect on diabetic retinopathy (DR) between oral antidiabetic drugs (OADs) alone and in combination with basal insulin‐supported OADs therapy (BOT). [Correction added on 11 November 2019, after first online publication: In Abstract under Background section, “DR” has been corrected into “diabetic retinopathy (DR)”.] Methods Between January 2015 and January 2018, this study enrolled 290 patients (age 18‐65 years) with diabetes duration between 0 and 5 years. Patients were randomly assigned to receive OADs or BOT after 14 days intensive insulin treatment. Examinations were performed at the beginning and end of the study. Results Fewer patients developed DR in the BOT than OADs group (8 [6.06%] vs 12 [8.3%], respectively), and all cases of DR were non‐proliferative. Blood glucose concentrations were higher in the BOT than OADs group at the 3rd month, but lower in the former at the 6th and 12th month. The rate of reaching target HbA1c ≤7% was lower in the BOT than OADs group at the 3rd month (63.6% vs 72.2%, respectively), similar between the two groups at the 6th month (60.6% vs 66.6%, respectively) and higher in the BOT group at the 12th month (75.0% vs 61.1%, respectively). The SD of fasting blood glucose (FBG), coefficient of variation of FBG, SD of blood glucose (SDBG), and mean amplitude of glycemic excursions were lower in the BOT than OADs group. Changes in the levels of three cytokines (interleukin [IL]‐1β, IL‐6, and IL‐17α) were significantly less in the BOT than OADs group. Conclusions Twelve months of BOT decreased the incidence of DR in short‐duration type 2 diabetes by reducing glycemia more effectively, stably, and completely than OADs alone.