目的:本研究调查了在英格兰初级实践中,初治胰岛素的2型糖尿病(T2D)患者在血糖水平和临床特征方面的种族差异。
方法:回顾性,观察性队列研究利用临床实践研究数据链数据库中的数据,包括怀特,南亚,黑色和中国的胰岛素幼稚成人与T2D,启动BIAsp30。索引日期是第一个BIAsp30处方的日期。终点包括糖化血红蛋白(HbA1c)和体重指数(BMI)后6个月的变化。
结果:总计,11186名符合条件的人被选中(9443名白人,1116南亚,594黑色,33中文)。指数后6个月,所有亚组的HbA1c均下降:估计的百分点变化[95%CI为-2.32(-2.36;-2.28)(白色);-1.91(-2.02;-1.80)(南亚);-2.55(-2.69;-2.40)(黑色);和-2.64(-3.24;-2.04)(中文)]。在所有亚组中,BMI指数在6个月后适度增加[估计变化(95%CI)kg/m2:白色,0.92(0.86;0.99);南亚,0.60(0.41;0.78);黑色,1.41(1.16;1.65);和中文,0.32(-0.67;1.30)]。在总人口中,低血糖事件发生率从指数前的每100例患者年0.92例事件增加到指数后的每100例患者年3.37例事件;事件数量太低,无法按亚组进行分析.
结论:在胰岛素初治T2D患者中,在所有种族中观察到有临床意义的HbA1c降低。一些种族比其他种族减少了更多,但差异很小。在所有组中,观察到BMI的小幅增加,组间观察到的差异很小。低血糖发生率低。
This study investigated the ethnic differences in glycaemic levels and clinical characteristics among insulin-naïve people with type 2 diabetes (T2D) initiating biphasic insulin aspart 30/70 (BIAsp 30) in primary practice in England.
Retrospective, observational cohort study utilizing data from the Clinical Practice Research Datalink Aurum database, including White, South Asian, Black and Chinese insulin-naïve adults with T2D, initiating BIAsp 30. The index date was that of the first BIAsp 30 prescription. Endpoints included change in glycated haemoglobin (HbA1c) and body mass index (BMI) 6 months post index.
In total, 11 186 eligible people were selected (9443 White, 1116 South Asian, 594 Black, 33 Chinese). HbA1c decreased across all subgroups 6 months post index: estimated %-point changes [95% CI of -2.32 (-2.36; -2.28) (White); -1.91 (-2.02; -1.80) (South Asian); -2.55 (-2.69; -2.40) (Black); and -2.64 (-3.24; -2.04) (Chinese)]. The BMI increased modestly 6 months post index in all subgroups [estimated changes (95% CI) kg/m2 : White, 0.92 (0.86; 0.99); South Asian, 0.60 (0.41; 0.78); Black, 1.41 (1.16; 1.65); and Chinese, 0.32 (-0.67; 1.30)]. In the overall population, hypoglycaemic event rates increased from 0.92 events per 100 patient-years before the index to 3.37 events per 100 patient-years post index; event numbers were too low to be analysed by subgroup.
Among insulin-naïve people with T2D initiating BIAsp 30, clinically meaningful HbA1c reductions in all ethnicities were observed. Some ethnic groups had larger reductions than others, but differences were small. In all groups, small BMI increases were seen, with small differences observed between groups. Hypoglycaemia rates were low.