中华医学杂志（英文版）2010，Vol.123Issue(24)：3684-3688,5.DOI:10.3760/cma.j.issn.0366-6999.2010.24.031
Appropriate insulin initiation dosage for insulin-naive type 2 diabetes outpatients receiving insulin monotherapy or in combination with metformin and/or pioglitazone
Appropriate insulin initiation dosage for insulin-naive type 2 diabetes outpatients receiving insulin monotherapy or in combination with metformin and/or pioglitazone
LIAO Lin 1YANG Ming 1QIU Lu-lu 2MOU Ya-ru 3ZHAO Jia-jun 4DONG Jian-jun4
作者信息
- 1. Division of Endocrinology, Department of Medicine, Provincial Hospital affiliated to Shandong University, Jinan, Shandong 250021, China
- 2. Department of Internal Medicine, Peking University People's Hospital, Beijing 100044, China
- 3. Division of Endocrinology, Department of Medicine, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China
- 折叠
摘要
Abstract
Background Few studies have given suggestions on appropriate initiation insulin dosage when combined with oral antidiabetic drugs (OADs). This research was to investigate appropriate initiation insulin doses for insulin-naive type 2diabetes patients with different combinations and the relationship between insulin dosage and relevant factors.Methods This was a randomized, open-label, treat to target study. The target was 20% decrease of both fasting plasma glucose (FPG) and 2 hours post-breakfast blood glucose (P2hBG). One hundred and forty-seven insulin-naive Chinese patients recruited were randomiy assigned to 3 groups: group A, patients received insulin monotherapy; group B, received insulin plus metformin (0.5 g, tid) and group C, received insulin plus metformin (0.5 g, tid) and pioglitazone (15 mg, qd).Results Both the time of getting 20% reduction of FPG and P2hBG showed significant differences among the three groups. The time was shortest in Group C. The insulin doses needed to achieve glucose reduction of 20% in three treatment groups were (0.40±0.04) U·kg-1·d-1 for Group A, (0.37±0.04) U·kg-1·d-1 for Group B, and (0.35±0.03) U·kg-1·d-1 for Group C, respectively. Multiple linear stepwise regression analysis showed that insulin doses correlated with body weight, FPG, diabetes duration, age and history of sulfonylurea treatment. The standardized regression coefficients were 0.871, 0.322, 0.089, 0.067 and 0.063 (with all P ＜0.05).Conclusions To achieve blood glucose's reduction of 20% within safety context, initial insulin doses were recommended as the following: 0.40 U·kg-1·d-1 for insulin mono-therapy, 0.37 U·kg-1·d-1 for insulin plus metformin treatment, and 0.35 U·kg-1.d-1 for insulin plus metformin and pioglitazone treatment in Chinese type 2 diabetes outpatients. Body weight is found the most closely related factor to the insulin dosage.关键词
initiation dosage/insulin/metformin/pioglitazone/type 2 diabetesKey words
initiation dosage/insulin/metformin/pioglitazone/type 2 diabetes分类
医药卫生引用本文复制引用
LIAO Lin,YANG Ming,QIU Lu-lu,MOU Ya-ru,ZHAO Jia-jun,DONG Jian-jun..Appropriate insulin initiation dosage for insulin-naive type 2 diabetes outpatients receiving insulin monotherapy or in combination with metformin and/or pioglitazone[J].中华医学杂志（英文版）,2010,123(24):3684-3688,5.
