规范基础胰岛素治疗,安全有效控糖

The standardized basal insulin treatment and optimal glycemic control

随着基础胰岛素的更新换代,其有效性、安全性不断提高。但是基础胰岛素的临床实践效果与RCT研究结果差距甚远。这与当前基础胰岛素治疗的"起始晚、时间短、剂量小、餐后高"等问题密切相关,即T2DM患者延迟优化治疗,尤其是延迟起始胰岛素治疗;起始胰岛素治疗的患者早期终止治疗的比例较高;基础胰岛素的用量不足;充分调整剂量后血糖仍不达标,没有优化餐后血糖管理方案等。《中国2型糖尿病防治指南(2013年版)》对于规范化的基础胰岛素治疗给出了推荐。规范的基础胰岛素治疗是血糖控制良好的保障。

With the development of basal insulin,its effectiveness and safety has been improved rapidly.But in the real world,its effectiveness still has large gap with what presented in RCT.The potential causes of unfavorable glycemic control with basal insulin may highly relate with＇late initiation,short treatment,low dose and high postprandial glucose＇,which includes the late treatment optimization,especially late insulin initiation;high discontinue treatment rate;low basal insulin dose and poor PPG management.The 2013 Chinese guideline of diabetic prevention and treatment gave detailed recommendations about basal insulin.The standardized basal insulin treatment can guarantee optimal glycemic control.