Assessment of factors determining an HbA1c concentration ≤7.5% in patients with type 1 diabetes
评估决定1型糖尿病患者HbA1c≤7.5%的因素
Abstract
enBackground
Establishing an optimal insulin regimen is crucial for maintaining glycemic control in patients with type 1 diabetes (T1D). The aim of the present study was to determine the insulin dose required to achieve an HbA1c concentration ≤7.5% in Japanese patients with T1D.
Methods
The present multicenter cross-sectional study was performed at three institutes in Japan. Information was collected regarding patient age, sex, body weight, body mass index (BMI), HbA1c, total daily insulin dose (TDD), and total basal insulin dose (TBD), and the effects of these factors on achieving HbA1c ≤7.5% were investigated.
Results
Of 107 patients with T1D, 92 had no detectable endogenous insulin secretion: 39 had HbA1c ≤7.5% (well-controlled group) and 53 had HbA1c >7.5% (poorly controlled group). No significant differences in age, sex, height, body weight, BMI, diabetes duration, stage of diabetic kidney disease, treatment, or TDD were noted between the poorly and well-controlled groups. The TBD as a percentage of TDD (%TBD) was lower in patients with well-controlled diabetes ( P < 0.05) after adjustment for age, gender, and diabetes duration. In the well-controlled group, TDD was correlated with body weight ( R = 0.51), BMI ( R = 0.44), body surface area ( R = 0.41), and TBD ( R = 0.73; P < 0.01 for all), but TBD was not correlated with BMI or body surface area. In our population, a %TBD of approximately 30% was appropriate, without considering BMI.
Conclusions
To achieve HbA1c ≤7.5 in patients with T1D, TDD should be calculated based on body weight, and the %TBD should be set at 30% in the Japanese population.
摘要
zh背景
制定出一个最佳的胰岛素治疗方案对于1型糖尿病(T1D)患者维持血糖控制至关重要。本研究旨在确定日本T1D患者HbA1c水平达到≤ 7.5%目标时所需要的胰岛素剂量。
方法
当前这项多中心的横断面研究是日本的3个研究中心完成。收集的相关信息包括患者年龄、性别、体重、体重指数(BMI)、HbA1c、每日总胰岛素剂量(total daily insulin dose, TDD)以及基础胰岛素总剂量(total basal insulin dose, TBD), 并且调查了这些因素对HbA1c达到≤ 7.5%的目标有何影响。
结果
在107名T1D患者中, 有92名没有检测到内源性胰岛素分泌:其中39名患者的HbA1c ≤ 7.5%(控制良好组), 53名患者的HbA1c > 7.5%(控制不佳组)。在控制不佳组与控制良好组之间没有发现年龄、性别、身高、体重、BMI、糖尿病病程、糖尿病肾病分期、治疗方法或TDD具有显著性差异。校正年龄、性别以及糖尿病病程后, 控制良好组糖尿病患者的TBD在TDD中所占的比例(%TBD)显著更低(P < 0.05)。在控制良好组中, TDD与体重(R = 0.51)、BMI(R = 0.44)、体表面积(R = 0.41)以及TBD(R = 0.73)都显著相关(所有的P值都< 0.01), 但是TBD与BMI或体表面积都没有相关性。在我们的研究人群中, 如果不考虑BMI, 比较适宜的%TBD大约为30%。
结论
在日本人群中, T1D患者为了达到HbA1c ≤ 7.5%的目标应该按照体重来计算TDD, 并且应将%TBD设置为30%。
