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首页> 外文期刊>Diabetic medicine: A journal of the British Diabetic Association >Less weight gain and hypoglycaemia with once-daily insulin detemir than NPH insulin in intensification of insulin therapy in overweight Type 2 diabetes patients: the PREDICTIVE BMI clinical trial.
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Less weight gain and hypoglycaemia with once-daily insulin detemir than NPH insulin in intensification of insulin therapy in overweight Type 2 diabetes patients: the PREDICTIVE BMI clinical trial.

机译：减少重量增益和低血糖患有次数胰岛素的胰岛素比NPH胰岛素在超重型2型糖尿病患者中加剧胰岛素治疗：预测性BMI临床试验。

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OBJECTIVE: To assess weight change when once-daily insulin detemir (detemir) or neutral protamine Hagedorn insulin (NPH) are used in already overweight Type 2 diabetes patients requiring intensified insulin therapy. RESEARCH DESIGN AND METHODS: This 26-week randomized, controlled trial included adults with Type 2 diabetes [glycated haemoglobin (HbA(1c)) 7.5-11.0%, body mass index (BMI) 25-40 kg/m(2)] who had received two daily doses of insulin (at least one a premix) for > or = 3 months. Subjects received either detemir (n = 125) or NPH (n = 146) once daily in the evening and insulin aspart at main meals. Concomitant treatment with metformin was allowed. Basal insulin was titrated to a pre-breakfast plasma glucose target of 6.1 mmol/l without unacceptable hypoglycaemia. Insulin aspart was also titrated (target, postprandial glucose < or = 10.0 mmol/l without unacceptable hypoglycaemia). RESULTS: At 26 weeks, weight had increased significantly less with detemir (0.4 kg) than with NPH (1.9 kg; difference1.5 kg, P < 0.0001). BMI increase was also less with detemir than with NPH (difference 0.6 kg/m(2), P < 0.0001). HbA(1c) decreased from 8.9 to 7.8% (detemir) and from 8.8 to 7.8% (NPH; not significant for between-treatment difference). Incidence of hypoglycaemia was lower with detemir [relative risks 0.62 (all events) and 0.43 (nocturnal); P < 0.0001 for both]. CONCLUSIONS: PREDICTIVE BMI was the first study to examine the effect of once-daily detemir with weight as the primary endpoint in a large population of overweight Type 2 diabetes patients. Use of once-daily detemir for intensification of insulin therapy resulted in less weight gain, less hypoglycaemia and equivalent glycaemic control compared with NPH.
机译：目的：评估一次每日胰岛素DECIMIR（DETIMIR）或中性protamine Hagageorn胰岛素（NPH）的重量转速2型糖尿病患者需要加剧胰岛素治疗的2型糖尿病患者。研究设计和方法：今年26周随机，受控试验包括2型糖尿病的成人[糖化血红蛋白（HBA（1C））7.5-11.0％，体重指数（BMI）25-40 kg / m（2）]谁已接受过两种每日剂量的胰岛素（至少一个预混物）>或= 3个月。在晚上和胰岛素Aspart在主要膳食中每天一次接受DECIMIR（n = 125）或NPH（n = 146）。允许伴随二甲双胍的处理。将基础胰岛素滴定到早餐前血浆葡萄糖靶为6.1mmol / L，没有不可接受的低血糖。还滴定胰岛素Aspart（靶，后葡萄糖<或= 10.0mmol / L，没有不可接受的低血糖）。结果：在26周时，Depemir（0.4千克）比NPH（1.9公斤;差异为1.5千克，P <0.0001），重量显着较小。 BMI增加也少于DETIMIR而不是NPH（差异0.6kg / m（2），p <0.0001）。 HBA（1C）从8.9降至7.8％（DECIMIR）和8.8％至7.8％（NPH;治疗差异不显着）。 Depemir的低血糖发病率降低[相对风险0.62（所有事件）和0.43（夜间）; P <0.0001两个]。结论：预测性BMI是第一项研究审查重量作为大量超重型2型糖尿病患者的主要终点的一次每日DEDIMIR的效果。与NPH相比，使用一次每日DECIMIR进行胰岛素治疗的强化导致体重减轻，低血糖和等同的血糖控制。

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