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首页> 外文期刊>Diabetes therapy >Comparison of Patient-Led and Physician-Led Insulin Titration in Japanese Type 2 Diabetes Mellitus Patients Based on Treatment Distress, Satisfaction, and Self-Efficacy: The COMMIT-Patient Study
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Comparison of Patient-Led and Physician-Led Insulin Titration in Japanese Type 2 Diabetes Mellitus Patients Based on Treatment Distress, Satisfaction, and Self-Efficacy: The COMMIT-Patient Study

机译：基于治疗窘迫，满意度和自我疗效的日本2型糖尿病患者患者LED和医生-ED胰岛素滴定的比较：提交患者研究

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IntroductionIn Japan, patient-led insulin titration is rare in type 2 diabetes mellitus (T2DM) patients. Few studies have compared the effects of patient-led versus physician-led insulin titration on patient-reported outcomes in Japanese T2DM patients. This study aimed to compare the effects of patient-led and physician-led insulin titration in Japanese insulin-na?ve T2DM patients on safety, glycemic control, and patient-reported outcomes (emotional distress, treatment satisfaction, and self-efficacy).MethodsUltimately, 125 insulin-na?ve Japanese T2DM patients were randomly assigned to either a patient-led insulin self-titration group or a physician-led insulin titration group and monitored for 24?weeks. The primary endpoint was a change in emotional distress as measured using the Problem Areas in Diabetes scale (PAID). Secondary endpoints included treatment satisfaction, as measured with the Diabetes Treatment Satisfaction Questionnaire (DTSQ), self-efficacy as measured using the Insulin Therapy Self-Efficacy Scale (ITSS), glycated hemoglobin (HbA1c) levels, fasting plasma glucose levels, body weight, insulin daily dose, and frequency of hypoglycemia.ResultsThere was no significant difference between the groups in PAID and DTSQ scores. The results for the primary endpoint should be interpreted taking account that the sample size for the power calculation was not reached. ITSS scores were significantly higher in the patient-led self-titration group. HbA1c and fasting plasma glucose levels were significantly decreased in both groups, but the decrease was significantly larger in the patient-led self-titration group. Although the insulin daily dose was significantly higher in the patient-led self-titration group, severe hypoglycemia did not occur in either group, and the frequency of hypoglycemia was similar in both groups.ConclusionSelf-measurement of blood glucose and self-titration of insulin enhanced the patients’ self-efficacy without compromising their emotional distress or treatment satisfaction. Also, insulin self-titration was found to be safe and effective; it resulted in better glycemic control without severe hypoglycemia.Trial registrationUniversity Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) (registration number: UMIN000020316).
机译：介绍日本，患者LED胰岛素滴定在2型糖尿病（T2DM）患者中罕见。少量的研究比较了患者LED与医生LED胰岛素滴定对日本T2DM患者患者报告的结果的影响。本研究旨在比较日本胰岛素-NAαveT2DM患者的患者主导和医生导向胰岛素滴定对安全，血糖控制和患者报告的结果（情绪困扰，治疗满意度和自我效能感）的影响。 poluertive，125例胰岛素-NAαve日本T2DM患者被随机分配给患者LED胰岛素自滴定组或医生LED胰岛素滴定组，并监测24个周。主要终点是使用糖尿病规模（支付）中的问题区域测量的情绪困扰的变化。次要终点包括治疗满意度，用糖尿病治疗满意度调查问卷（DTSQ），使用胰岛素治疗自效尺度（ITS），糖化血红蛋白（HBA1C）水平，禁食血浆葡萄糖水平，体重，体重胰岛素日常剂量，低血糖血症的频率。支付和DTSQ分数的组之间没有显着差异。应解释主要端点的结果考虑到未达到功率计算的样本量。患者LED自滴定组的分数显着较高。两组的HBA1C和空腹血浆葡萄糖水平显着降低，但患者LED自滴定组中的降低显着较大。虽然患者LED自滴定组胰岛素日剂量显着较高，但在任一组中，严重的低血糖在两组中没有发生，并且两组中的低血糖血症的频率相似。血糖测量血糖和胰岛素的自滴定的测量增强患者的自我效能，而不会影响他们的情绪困扰或治疗满意度。此外，发现胰岛素自滴定是安全有效的;它导致更好的血糖控制而没有严重的低血糖.TRIAL讲话医院医疗信息网络临床试验登记处（UMIN-CTR）（注册号：UMIN000020316）。

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