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Predictors of achieving HbA(1c) < 7% and no hypoglycaemia 6 months after initiation of biphasic insulin aspart 30 in patients with type 2 diabetes in the IMPROVE study

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单位: [1]Univ Paris 13, Jean Verdier Hosp, Dept Endocrinol Diabetol Nutr, Bondy, France [2]Windsor Reg Hosp, Windsor, ON, Canada [3]Gen Hosp Athens Polyklin, Ctr Diabet, Athens, Greece [4]Juntendo Univ, Sch Med, Dept Endocrinol & Metab, Tokyo 113, Japan [5]Vittorio Emanuele Hosp, Dept Internal Med, Catania, Italy [6]Bhatia Hosp, Dept Endocrinol, Mumbai, Maharashtra, India [7]China Japan Friendship Hosp, Dept Endocrinol, Beijing, Peoples R China [8]Novo Nordisk AS, Bagsvaerd, Denmark [9]Med Univ Silesia, Dept Internal Dis Diabetol & Nephrol, Katowice, Poland
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关键词: Biphasic insulin aspart 30 Clinical inertia Insulin therapy Type 2 diabetes

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Background: Early initiation of insulin therapy has widely been associated with numerous benefits, including improved glycaemic control and reduced long-term risk of developing microvascular diseases. Biphasic insulins offer a convenient option for insulin initiation, addressing both basal and postprandial insulin requirements with one injection, making them relatively simple for patients to dose. Development of biphasic insulin aspart (BIAsp) has further offered improved postprandial glycaemic control and lower rates of nocturnal and major hypoglycaemia than biphasic human insulin. Methods: The safety and efficacy of the 30/70 rapid-acting/intermediate-acting formulation of BIAsp (BIAsp 30) in patients with type 2 diabetes was examined in the IMPROVE study, a 26-week, international, observational trial. In this subanalysis, baseline clinical factors that predicted treatment success, defined as HbA(1c) <7% (<53 mmol/mol) without experiencing hypoglycaemia after 26 weeks on BIAsp 30 therapy, were assessed. Results: The composite endpoint was defined for 44,010 (77%) patients from the total cohort of 57,478, and 28,696 of these were included in the statistical examination. The results of the analysis suggest that those with lower baseline HbA1c of <= 8% (<= 64 mmol/mol), shorter duration of diabetes at baseline (<5 years) and no incidence of major hypoglycaemia at 13 weeks, or minor hypoglycaemia at 4 weeks, before the beginning of the trial were more likely to achieve treatment success. Conclusion: Lower baseline HbA(1c), shorter duration of diabetes and no incidence of hypoglycaemia up to 13 weeks prior to initiation are predictors of achieving HbA(1c) <7% without hypoglycaemia with a BIAsp 30 regimen. These results suggest that it is easier to reach target without hypoglycaemia with BIAsp 30 when prescribed earlier. As this was an observational study, lack of control groups or randomisation, as well as varying clinical practices in study countries, potentially introduced bias.

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出版当年[2012]版:
大类 | 3 区 医学
小类 | 3 区 医学:内科 3 区 医学:研究与实验
最新[2025]版:
大类 | 4 区 医学
小类 | 3 区 医学:内科 4 区 医学:研究与实验
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出版当年[2011]版:
Q1 MEDICINE, GENERAL & INTERNAL Q2 MEDICINE, RESEARCH & EXPERIMENTAL
最新[2023]版:
Q1 MEDICINE, GENERAL & INTERNAL Q3 MEDICINE, RESEARCH & EXPERIMENTAL

影响因子: 最新[2023版] 最新五年平均[2021-2025] 出版当年[2011版] 出版当年五年平均[2007-2011] 出版前一年[2010版] 出版后一年[2012版]

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第一作者单位: [1]Univ Paris 13, Jean Verdier Hosp, Dept Endocrinol Diabetol Nutr, Bondy, France [*1]Hop Jean Verdier, Serv Endocrinol Diabetol Nutr, Ave 14 Juillet, F-93143 Bondy, France
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通讯机构: [1]Univ Paris 13, Jean Verdier Hosp, Dept Endocrinol Diabetol Nutr, Bondy, France [*1]Hop Jean Verdier, Serv Endocrinol Diabetol Nutr, Ave 14 Juillet, F-93143 Bondy, France
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