甘精胰岛素联合口服降糖药对2型糖尿病患者血糖波动性的影响

摘要

目的 研究甘精胰岛素联合口服降糖药对2型糖尿病患者血糖波动性的影响.方法 以63例2型糖尿病患者为研究对象,将其分为甘精胰岛素联合口服阿卡波糖组(联合组,32例)和预混胰岛素组(预混组,31例),联合组每日给予皮下注射甘精胰岛素及餐前口服阿卡波糖,每日3次.预混组每日2次皮下注射门冬胰岛素.治疗2周后,监测并比较患者血糖变化,记录胰岛素使用情况.结果经过2周治疗后,联合组平均胰岛素使用量明显少于预混组,低血糖的发生率为40.63%,明显少于预混组(83.87%),两组比较差异有高度统计学意义(P ＜ 0.01).治疗2周后两组平均血糖水平及高血糖曲线下面积(AUC)比较差异无统计学意义(P ＞ 0.05),而联合组标准差、每日平均血糖波动幅度及低血糖AUC明显低于预混组,两组比较差异有高度统计学意义(P ＜ 0.01).结论 口服降糖药对2型糖尿病控制不良时,联合应用甘精胰岛素能使血糖控制在较稳定水平,且血糖波动小,低血糖发生率相对较低.%Objective To study the influence of Insulin Glargine with oral hypoglycemic agents on volatility of blood sugar in patients with type 2 diabetes. Methods 63 patients with type 2 diabetes were divided into Insulin Glargine combined with oral Acarbose group (combined group, 32 cases) and premixed Insulin group (premixed group, 31 cases). Patients in the combined group were given Insulin Glargine, daily subcutaneous injection, and taking Acarbose, three times a day. Patients in the premixed group were given insulin aspart twice daily subcutaneous injection. Two weeks after the treatment, the changes of blood glucose were monitored and compared, the use of insulin was recorded. Results After 2 weeks of treatment, the mean insulin use was significantly less than the premixed group, the incidence of hypo-glycemia in the combined group (40.63%) was significantly less than the premixed group (83.87%), there was a statistically significant difference (P< 0.01). After two weeks of treatment, there were no significant differences about mean blood sugar levels and high blood glucose area under the curve (AUC) between two groups (P > 0.05), while standard deviation, the average daily blood sugar fluctuations and low glucose AUC in the combined group was significantly lower than the premixed group, there were statistically significant differences (P < 0.01). Conclusion When oral hypoglycemic agents control type 2 diabetes poorly, Insulin Glargine combined with oral hypoglycemic agents enables blood glucose control in a more stable level. Also it has small volatility in blood glucose and the relatively low incidence of hypoglycemia.