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【medical-news】长效胰岛素在加强血糖控制中的作
The newer agents do offer one clear advantage over the older preparations; the risk of hypoglycemia, especially at night, is reduced, according to the findings reported in the latest issue of The Cochrane Library.
"Long-acting insulin preparations have gained much popularity in recent years for the treatment of type 1 diabetes mellitus," lead author Dr. Moshe Vardi, from Carmel Medical Center in Haifa, Israel, said in a statement. "We were surprised to find such a minor advantage in the overall glucose-lowering abilities of the long-acting drugs compared to the older, intermediate-acting drugs."
The findings stem from a review of 23 randomized, controlled trials that were identified through a search of MEDLINE, EMBASE, The Cochrane Library, and ongoing trial databases. Data from more than 6500 subjects were included in the analysis.
The weighted mean difference (WMD) for HbA1c levels was –0.08, favoring long-acting over intermediate-acting preparations. Similarly, the WMD for fasting plasma and blood glucose levels also favored the long-acting agents with values of –0.63 and –0.86, respectively.
Overall, hypoglycemia episodes were 7% less likely with long-acting insulin preparations. In terms of severe and nocturnal episodes, such preparations cut the risks by 27% and 30%, respectively.
For overall, severe, and nocturnal hypoglycemic episodes, the WMD between long- and intermediate-acting preparations (per 100 patient follow-up days) were –0.77, –0.0, –0.40, respectively.
Weight gain was more apparent in patients treated with the intermediate-acting agents. No significant differences in the rate or character of adverse events were noted between the drug types.
Despite the relatively small benefit in glycemic control, the long-acting insulin preparations are likely to remain the favored agents for type 1 diabetes due to the reduced risk of hypoglycemia, according to Dr. Irl Hirsch, a diabetes expert with the University of Washington in Seattle.
Since these preparations have become available, "the reduction in the frequency of hypoglycemia has been profound," Dr. Hirsch said in a statement. "Insulin analogues have totally revolutionized our ability to reduce hypoglycemia with diabetes in the US."
Cochrane Database Syst Rev. Published online July 16, 2008. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 长效胰岛素在加强血糖控制中的作用有限
July 25, 2008 — An analysis of trial data suggests that the newer long-acting insulin preparations, such as glargine and detemir, used to provide basal insulin replacement in patients with type 1 diabetes offer only slightly better glycemic control than intermediate-acting preparations.
2008.7.25－对试验数据的分析表明新的长效胰岛素－比如甘精胰岛素、detemir（地特胰岛素），当使用它们对I型糖尿病患者提供基础的胰岛素替代治疗时，血液中胰岛素水平仅比使用中效胰岛素治疗时略微升高。 个人理解，仅供参考：
The findings stem from a review of 23 randomized, controlled trials that were identified through a search of MEDLINE, EMBASE, The Cochrane Library, and ongoing trial databases. Data from more than 6500 subjects were included in the analysis.
这些发现是来自于对Cochrane图书馆MEDLINE,EMBASE中搜索到的和正在进行的试验中的23个随机、对照的试验的分析，这些数据包括包括大于6500个患者。
这些结果源自对Cochrane图书馆、MEDLINE、EMBASE等数据库中检索到的和正在进行的的23项随机对照试验的分析，共计超过6500位患者纳入此次分析。
anmb1 wrote:
The findings stem from a review of 23 randomized, controlled trials that were identified through a search of MEDLINE, EMBASE, The Cochrane Library, and ongoing trial databases. Data from more than 6500 subjects were included in the analysis.
这些发现是来自于对Cochrane图书馆MEDLINE,EMBASE中搜索到的和正在进行的试验中的23个随机、对照的试验的分析，这些数据包括包括大于6500个患者。
这些结果源自对Cochrane图书馆、MEDLINE、EMBASE等数据库中检索到的和正在进行的的23项随机对照试验的分析，共计超过6500位患者纳入此次分析。[标签:content1][标签:content2]阅读本文的人还阅读：
作者:admin@医学,生命科学 2011-09-01 05:14
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