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首页> 外文期刊>Diabetes, obesity & metabolism >Prevention of weight gain in type 2 diabetes requiring insulin treatment.
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Prevention of weight gain in type 2 diabetes requiring insulin treatment.

机译：预防需要胰岛素治疗的2型糖尿病患者体重增加。

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BACKGROUND: Patients with type 2 diabetes who are failing on oral agents will generally gain a large amount of body fat when switched to insulin treatment. This adverse effect may be related to chronic hyperinsulinism induced by long-acting insulin compounds. AIM: To test the concept that regain of glycaemic control can be achieved without causing weight gain, using a regimen free of long-acting insulin. METHODS: In a 3-month open-label pilot study including 25 patients with moderate overweight and secondary failure, we investigated whether nocturnal glycaemic control could be achieved with glimepiride administered at 20:00 hours. The starting dose was 1-2 mg, with subsequent titration up to a maximum of 6 mg. Rapid-acting insulin analogues were used three times daily to regain postprandial glucose control. RESULTS: Glycaemic control at 3 months was established with glimepiride in a dose of 4.4 +/- 0.3 mg/day (mean +/- standard error of the mean), and a total daily insulin dose of 24.1 +/- 2.6 IU. Fasting glucose levels decreased from 12.7 +/- 0.6 mmol/l to 8.1 +/- 0.3 mmol/l (p < 0.001), and target levels were reached in 14 of 25 patients (56%). Mean HbA1c decreased from 10.5 +/- 0.4 to 7.7 +/- 0.2% (p < 0.001). Symptomatic nocturnal hypoglycaemia was not reported. Body weight did not change (85.7 +/- 3.6 kg vs. 85.7 +/- 3.3 kg, p = 0.99). CONCLUSION: The data suggest that this new approach may be useful in about 50% of type 2 diabetes patients presenting with failure on maximal oral treatment.
机译：背景：口服药物治疗失败的2型糖尿病患者通常会在接受胰岛素治疗时增加大量体内脂肪。这种不良影响可能与长效胰岛素化合物诱发的慢性高胰岛素血症有关。目的：使用无长效胰岛素的方案，测试可以实现血糖控制的恢复而不引起体重增加的概念。方法：在一项为期3个月的开放标签试验研究中，包括25名中度超重和继发性衰竭患者，我们调查了格列美脲在20:00小时是否可以实现夜间血糖控制。起始剂量为1-2 mg，随后滴定最高为6 mg。每天使用速效胰岛素类似物3次，以恢复餐后血糖控制。结果：使用格列美脲以4.4 +/- 0.3毫克/天的剂量（平均数的+/-标准误差）和34.1的每日胰岛素总剂量建立了3个月的血糖控制。空腹血糖水平从12.7 +/- 0.6 mmol / l降至8.1 +/- 0.3 mmol / l（p <0.001），并且25位患者中有14位达到了目标水平（56％）。平均HbA1c从10.5 +/- 0.4降至7.7 +/- 0.2％（p <0.001）。没有报道有症状的夜间低血糖症。体重没有变化（85.7 +/- 3.6公斤vs. 85.7 +/- 3.3公斤，p = 0.99）。结论：数据表明，这种新方法可能对大约50％的最大口服治疗失败的2型糖尿病患者有用。

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