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首页> 外文期刊>Diabetes/metabolism research and reviews >Patterns of postprandial hyperglycemia after basal insulin therapy: Individual and regional differences
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Patterns of postprandial hyperglycemia after basal insulin therapy: Individual and regional differences

机译：基础胰岛素治疗后餐后高血糖的模式：个体和区域差异

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Background: Treatment of postprandial hyperglycemia could be needed when basal insulin added to oral therapy does not maintain glycated haemoglobin (HbA1C) targets in type 2 diabetes mellitus. Knowing individual and regional patterns of postprandial hyperglycemia in this setting might improve therapeutic decisions. Methods: Patient-level self-monitored blood glucose data were pooled from six studies of insulin glargine for patients with HbA1C≥7.0% after 24weeks. Percentages of participants with highest daily postprandial blood glucose and greatest postprandial increments after each of the three daily meals were calculated and compared between four geographical regions; USA, Canada, Germany, and other European countries. Results: For 494 participants (mean age 60.1years, diabetes duration 9.6years, and BMI 29.8kg/m2), mean endpoint HbA1C was 7.8%. On insulin glargine treatment, highest postprandial blood glucose most often occurred post-dinner (44% of participants) and greatest postprandial increments post-breakfast (46% of participants) in all regions. Participants with greatest postprandial increments post-breakfast were older and experienced less HbA1C improvement with insulin glargine than those with greatest postprandial increments after other meals. Post-breakfast and post-dinner postprandial blood glucose was higher in the USA and Canada versus Germany, and in the USA versus Other European countries (all p0.05). Postprandial increments after dinner were greater in the USA versus all other regions. Conclusions: Generally, highest postprandial blood glucose follows dinner and greatest postprandial increments follow breakfast. Variations in patient characteristics and eating patterns might underlie differences both within and between regions. Awareness of regional differences and evaluation of an individual's typical eating pattern might facilitate appropriate prandial therapy.
机译：背景：当口服胰岛素添加的基础胰岛素不能维持2型糖尿病患者糖化血红蛋白（HbA1C）指标时，可能需要治疗餐后高血糖。了解这种情况下餐后高血糖的个体和区域模式可能会改善治疗决策。方法：从六项甘精胰岛素的研究中收集了24周后HbA1C≥7.0％的患者水平的自我监测血糖数据。计算每日三餐中每餐后每日餐后血糖最高和餐后增量最大的参与者的百分比，并在四个地理区域之间进行比较;美国，加拿大，德国和其他欧洲国家。结果：对于494名参与者（平均年龄60.1岁，糖尿病持续时间9.6年和BMI 29.8kg / m2），平均终点HbA1C为7.8％。在进行甘精胰岛素治疗时，所有地区的餐后血糖最高发生在餐后（占参与者的44％），早餐后的餐后增量最大（占参与者的46％）。早餐后餐后增幅最大的参与者比其他餐后餐后增幅最大的参与者年龄更大，胰岛素甘精胰岛素的HbA1C改善较少。早餐后和餐后餐后血糖在美国和加拿大相对于德国较高，在美国相对于其他欧洲国家较高（所有p <0.05）。与所有其他地区相比，美国晚餐后的餐后增量更大。结论：通常，晚餐后餐后血糖最高，早餐后餐后增量最大。患者特征和饮食方式的变化可能是区域内部和区域之间差异的基础。意识到区域差异并评估个人的典型饮食方式可能有助于适当的饮食疗法。

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