The Use of Rescue Insulin in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE)

作者：Priscilla Hollander, Heidi Krause‐Steinrauf, Nicole M. Butera, Erin J. Kazemi, Andrew Ahmann, Basma N. Fattaleh, Mary L. Johnson, Tina Killean, Violet S. Lagari, Mary Larkin, Elizabeth A. Legowski, Neda Rasouli, Holly Willis, Catherine L. Martin, Jill P. Crandall, M. Diane McKee, S. Behringer-Massera, J. Brown-Friday, E. Xhori, K. Ballentine-Cargill, S. Duran, H. Estrella, S. Gonzalez de la torre, J. Lukin, Lawrence S. Phillips, Elizabeth Burgess, Darin E. Olson, M. Rhee, Philip Wilson, T.S. Raines, J. Boers, J. Costello, M. Maher-Albertelli, R. Mungara, L. Savoye, C.A. White, C. Gullett, Leah Holloway, F. Morehead, S. Person, M. Sibymon, S. Tanukonda, Cynthia Adams, A. Ross, A. Balasubramanyam, Ruchi Gaba, E. Gonzalez Hattery, A. Ideozu, J. Jimenez, G. Montes, C. Wright, Priscilla Hollander, E. Roe, A. Jackson, A. Smiley, P. Burt, L. Estrada, K. Chionh, F. Ismail-Beigi, C. Falck-Ytter, L. Sayyed Kassem, Anil K. Sood, M. Tiktin, T. Kulow, C. Newman, K.A. Stancil, B. Cramer, J. Iacoboni, M.V. Kononets, C. Sanders, Lisa Tucker, A. Werner, A. Maxwell, G. McPhee, C. Patel, L. Colosimo, A. Krol, Robin Goland, J. Pring, L. Alfano, P. Kringas, C. Hausheer, J. Tejada, K. Gumpel, A. Kirpitch, H. Schneier, J.B. Green, H. AbouAssi, Ranee Chatterjee, Mark N. Feinglos, J. English Jones, S.A. Khan, J.B. Kimpel, R.P. Zimmer, M. Furst, B.M. Satterwhite, C.R. Thacker, K. Evans Kreider, Cary N. Mariash, Kieren J. Mather, H.M. Ismail, A. Lteif, T. Hamilton, N. Patel, G. Riera, Merry Jackson, V. Pirics, D. Aguillar, D. Howard, S. Hurt, Richard M. Bergenstal, Anders L. Carlson, Thomas Martens, Matthew Johnson, R. Hill, J. Hyatt, C. Jensen, M. Madden, Dianna C. Martin, H. Willis, W. Konerza, S. Yang, K. Kleeberger, R. Passi, S. Fortmann, M. Herson, K. Mularski, Harry Glauber, J. Prihoda, B. Ash, C. Carlson, P.A. Ramey, E. Schield, B. Torgrimson-Ojerio, K. Arnold, B. Kauffman, E. Panos, S. Sahnow, K. Bays, K. Berame, Jennifer Cook, D. Ghioni, J. Gluth, K. Schell, J. Criscola, C. Friason, Steve Jones, С. А. Назаров, Joshua I. Barzilay, N. Rassouli, R. Puttnam, B. Ojoawo, R. Nelson, Michelle Curtis, B. Hollis, C. Sanders-Jones, K. Stokes, Z. El-Haqq, A. Kolli, Tú-Anh Tran, Deborah J. Wexler, Mary Larkin, James B. Meigs, B. Chambers, A. Dushkin, G. Rocchio, M. Yepes, Barbara Steiner, H. Dulin, M. Cayford, K. Chu, A. DeManbey, M. Hillard, Kimberly Martin, N. Thangthaeng, L. Gurry, R. Kochis, E. Raymond, V. Ripley, Christine Stevens, Jaebum Park, Vanita R. Aroda, Adline Ghazi, Michelle Magee, A. Ressing, A. Loveland, M. Hamm, Maria D. Hurtado, Alexander Kuhn, J. Leger, L. Manandhar, F. Mwicigi, O. Sanchez, T. Young, Rajesh Garg, V. Lagari-Libhaber, H.J. Florez, W.M. Valencia, J. Marks, Sabina Casula, L. Oropesa-Gonzalez, L. Hue, A. Cuadot, R. Nieto-Martinez, A.K. Riccio Veliz, M. Gutt, Y.J. Kendal, B. Veciana, Andrew Ahmann, D. Aby-Daniel, F. Joarder, V. Morimoto, C. Sprague, D. Yamashita, N. Cady, N. Rivera-Eschright, P. Kirchhoff, B. Morales Gomez, J. Adducci, A. Goncharova, S.H. Hox, H. Petrovitch, M. Matwichyna, Victoria Jenkins, L. Broadwater, R.R. Ishii, N.O. Bermudez, Daniel S. Hsia, William T. Cefalu, Frank L. Greenway, C. Waguespack, E. King, G. Fry, A. Dragg, B. Gildersleeve, J. Arceneaux, Natalie Haynes, A. Thomassie, M. Pavlionis, B. Bourgeois, C. Hazlett, Sunder Mudaliar, Robert R. Henry, S. Boeder, Jeremy Pettus, E. Diaz, D. Garcia-Acosta, S. Maggs, C. DeLue, A. Stallings, E. Castro, S. Hernández, Jonathan Krakoff, Jeffrey M. Curtis, Tina Killean, Mohammed Khalid, E. Joshevama, K. Tsingine, T. Karshner, Jeanine Albu, F.X. Pi-Sunyer, S. Frances, C. Maggio, E. Ellis, J. Bastawrose, Xiuqun Gong, Mary Ann Banerji, Phyllis August, Melissa Lee, Daniel Lorber, N.M. Brown, D.H. Josephson, L.L. Thomas, M. Tsovian, A. Cherian, M.H. Jacobson, M.M. Mishko, M.S. Kirkman, John B. Buse, Jamie Diner, J. Dostou, S. Machineni, Laura Young, K. Bergamo, A. Goley, J. B. Kerr, J.F. Largay, S. Guarda, J. Cuffee, D. Culmer, R. Fraser, H. Almeida, S. Coffer, E. Debnam, L. Kiker, Sarah U. Morton, K. Josey, G. Fuller, W. Timothy Garvey, A.L. Cherrington, D. Dyer, M.C.R. Lawson, O. Griffith, A. Agne, S. McCullars, Robert M. Cohen, J. Craig, M.C. Rogge, Kathryn Burton, K. Kersey, Charlton Wilson, S. Lipp, M.B. Vonder Meulen, C. Adkins, T. Onadeko, Neda Rasouli, C. Baker, Emily B. Schroeder, M. Razzaghi, Corey Lyon, R. Penaloza, C. Underkofler, R. Lorch, Sarah A. Douglass, S. Steiner, William I. Sivitz, E. Cline, L.K. Knosp, J. McConnell, T. Lowe, William H. Herman, Rodica Pop‐Busui, Meng H. Tan, C. Martin, A. Waltje, A. Katona, L. Goodhall, R. Eggleston, Shihchen Kuo, S. Bojescu, S. Bule, N. Kessler, E. LaSalle, K. Whitley, Elizabeth R. Seaquist, A. Bantle, T. Harindhanavudhi, Anjali Kumar, B. Redmon, John P. Bantle, M. Coe, M. Mech, A. Taddese, Lesia Lesne, Shannon D. Smith, Cyrus Desouza, L. Kuechenmeister, V. Shivaswamy, S. Burbach, M.G. Rodriguez, K. Seipel, A. Alfred, A.L. Morales, J. Eggert, G. Lord, W. Taylor, R. Tillson, David S. Schade, A. Adolphe, Mark R. Burge, E. Duran-Valdez, J. Martinez, A. Bancroft, S. Kunkel, F. Ali Jamaleddin Ahmad, D. Hernandez McGinnis, B. Pucchetti, E. Scripsick, A. Zamorano, Ralph A. DeFronzo, Eugênio Cersósimo, M. Abdul-Ghani, Curtis Triplitt, D. Juarez, M. Mullen, R.I. Garza, H. Verastiqui, K. Wright, Curtiss Puckett, Philip Raskin, C. Rhee, S. Abraham, L.F. Jordan, S. Sao, L. Morton, O. Smith, L. Osornio Walker, L. Schnurr-Breen, R. Ayala, R.B. Kreymer, D. Sturgess, K.M. Utzschneider, Steven E. Kahn, L. Alarcon-Casas Wright, Edward J. Boyko, E.C. Tsai, D.L. Trence, S. Trikudanathan, B.N. Fattaleh, B.K. Montgomery, K.M. Atkinson, A. Kozedub, Tessa Concepcion, C. Moak, N. Prikhodko, S. Rhothisen, T.A. Elasy, S. Martin, L. Shackelford, R. Goidel, N. Hinkle, C. Lovell, J. Myers, J. Lipps Hogan, Janet B. McGill, M. Salam, T. Schweiger, S. Kissel, Carol Recklein, M.J. Clifton, William V. Tamborlane, A. Camp, Barbara Gulanski, Silvio E. Inzucchi, Kim Pham, M. Alguard, P. Gatcomb, K. Lessard, M. Perez, L. Iannone, E. Magenheimer, A. Montosa, Judith Fradkin, Henry B. Burch, A.A. Bremer, David M. Nathan, John M. Lachin, H. Krause-Steinrauf, Naji Younes, Ionut Bebu, Nicole M. Butera, C.J. Buys, A. Fagan, Yuping Gao, Amerta Ghosh, M.R. Gramzinski, S.D. Hall, Elham Kazemi, E. Legowski, H. Liu, C. Suratt, Mark Tripputi, A. Arey, M. Backman, J. Bethepu, C. Lund, P. Mangat Dhaliwal, P. McGee, E. Mesimer, Lisa Ngo, Michael W. Steffes, Jesse C. Seegmiller, Amy K. Saenger, Valerie Arends, D. Gabrielson, T. Conner, S. Warren, John Day, J. Huminik, A. Scrymgeour, Yashashwi Pokharel, Z.M. Zhang, C. Campbell, Jingzhou Hu, Lisa Keasler, S. Hensley, Y. Li, Rada Mihalcea, D.J. Min, V. Perez-Rosas, Lisa A. Prosser, Ken Resnicow, W. Ye, Hui Shao, P. Zhang, D. Sanchez, Stephanie Assuras, Erik J. Groessl, F. Sakha, H. Chong, N. Hillery, B.M. Everett, I. Abdouch, G. Bahtiyar, P. Brantley, F.E. Broyles, G. Canaris, Paul M. Copeland, J.J. Craine, W.L. Fein, A. Gliwa, L. Hope, M.S. Lee, R. Meiners, V. Meiners, H. O’Neal, J.E. Park, Alan Sacerdote, E. Sledge, L. Soni, J. Steppel-Reznik, Alexander Turchin · 发表于：Diabetes Care · 年份：2023 · DOI：10.2337/dc23-0516 · 被引用次数：6 · 研究领域：Diabetes Treatment and Management、Diabetes Management and Research、Diabetes, Cardiovascular Risks, and Lipoproteins

OBJECTIVE: To describe rescue insulin use and associated factors in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE). RESEARCH DESIGN AND METHODS: GRADE participants (type 2 diabetes duration <10 years, baseline A1C 6.8%-8.5% on metformin monotherapy, N = 5,047) were randomly assigned to insulin glargine U-100, glimepiride, liraglutide, or sitagliptin and followed quarterly for a mean of 5 years. Rescue insulin (glargine or aspart) was to be started within 6 weeks of A1C >7.5%, confirmed. Reasons for delaying rescue insulin were reported by staff-completed survey. RESULTS: Nearly one-half of GRADE participants (N = 2,387 [47.3%]) met the threshold for rescue insulin. Among participants assigned to glimepiride, liraglutide, or sitagliptin, rescue glargine was added by 69% (39% within 6 weeks). Rescue aspart was added by 44% of glargine-assigned participants (19% within 6 weeks) and by 30% of non-glargine-assigned participants (14% within 6 weeks). Higher A1C values were associated with adding rescue insulin. Intention to change health behaviors (diet/lifestyle, adherence to current treatment) and not wanting to take insulin were among the most common reasons reported for not adding rescue insulin within 6 weeks. CONCLUSIONS: Proportionately, rescue glargine, when required, was more often used than rescue aspart, and higher A1C values were associated with greater rescue insulin use. Wanting to use noninsulin strategies to improve glycemia...