OBJECTIVE To determine whether diabetes mellitus (DM) contributes to the drug resistance of carbamazepine (CBZ), we investigated the correlation between the blood glucose status and the CBZ resistance condition in patients with trigeminal neuralgia (TN). PATIENTS AND METHODS A total of 155 TN patients treated with the CBZ monotherapy were selected at Shanghai General Hospital and Shanghai Xinhua Hospital from September 2018 to January 2020. Among them, 15 were diagnosed with DM. Patients' CBZ resistance levels were evaluated according to progression-free survival. We utilized ordered multiple classification logistic regression to determine the dominant factors leading to CBZ resistance. We analyzed the correlation between hemoglobin A1c (HbA1c) and progression-free survival using the Pearson correlation analysis. RESULTS The regression analysis showed that DM was the only factor affecting CBZ resistance (p = 0.035; OR = 0.327; 95% CI, 0.115-0.926). Progression-free survival was 28.5 ± 21.2 months in the DM group and 66.0 ± 33.2 months in the non-DM group. The concentration of HbA1c in the blood was negatively correlated with progression-free survival (r = - 0.197; p = 0.014). CONCLUSIONS This study shows that blood glucose status is a significant factor contributing to the CBZ resistance in the treatment of TN. The progression-free survival of patients is affected by the status of DM and blood HbAlc levels.

中文翻译：

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糖尿病导致三叉神经痛患者对卡马西平耐药。

目的为了确定糖尿病（DM）是否对卡马西平（CBZ）的耐药性起作用，我们调查了三叉神经痛（TN）患者的血糖状态与CBZ耐药状况之间的相关性。患者与方法自2018年9月至2020年1月，在上海总医院和上海新华医院共收治155例接受CBZ单药治疗的TN患者。其中15例被诊断为DM。根据无进展生存期评估患者的CBZ抵抗水平。我们利用有序多分类逻辑回归来确定导致CBZ抗性的主导因素。我们使用Pearson相关分析分析了血红蛋白A1c（HbA1c）与无进展生存期之间的相关性。结果回归分析表明DM是影响CBZ耐药性的唯一因素（p = 0.035; OR = 0.327; 95％CI，0.115-0.926）。DM组无进展生存期为28.5±21.2个月，非DM组为66.0±33.2个月。血液中HbA1c的浓度与无进展生存率呈负相关（r =-0.197; p = 0.014）。结论这项研究表明，血糖水平是影响TN治疗中CBZ耐药性的重要因素。DM和血液中HbAlc的水平会影响患者的无进展生存期。血液中HbA1c的浓度与无进展生存率呈负相关（r =-0.197; p = 0.014）。结论这项研究表明，血糖水平是影响TN治疗中CBZ耐药性的重要因素。DM和血液中HbAlc的水平会影响患者的无进展生存期。血液中HbA1c的浓度与无进展生存率呈负相关（r =-0.197; p = 0.014）。结论这项研究表明，血糖水平是影响TN治疗中CBZ耐药性的重要因素。DM和血液中HbAlc的水平会影响患者的无进展生存期。