3种胰岛素强化降糖方案治疗2型糖尿病的疗效观察

摘要

目的 观察难治性2型糖尿病患者分别应用地特胰岛素、甘精胰岛素、中效胰岛素联合门冬胰岛素强化降糖治疗的疗效和低血糖发生率.方法 选取难治性2型糖尿病患者90例,分别给予地特胰岛素、甘精胰岛素、中效胰岛素联合门冬胰岛素降糖治疗,比较胰岛素用量,血糖控制情况,体质量变化,低血糖发生情况等.结果 3组降糖效果间比较差异无统计学意义(P＞0.05);地特胰岛素组体质量增加明显低于甘精胰岛素组和中效胰岛素组(P＜0.05);中效胰岛素组低血糖发生率较前2组明显升高,地特胰岛素组和甘精胰岛素组低血糖发生率相近.结论 难治性2型糖尿病患者应用胰岛素强化降糖治疗,地特胰岛素在安全性及体质量增加方面更有优势.%Objective To compare the efficacy and safety of three methods of insulin detemir, and insulin glargine and novolin N combined with insulin aspart for the refractory patients with type 2 diabetes. Methods Ninety type 2 diabetic patients were randomly divided into three groups, group A ( n = 30, with insulin detemir combined with insulin aspart ), group B ( n = 30, with insulin glargine combined with insulin aspart ) and group C( n =30, with novolin N combined with insulin aspart ). Efficacy parameters before and after treatment including fasting plasma glucose ( FPG ) and 2 - hour postprandial plasma glucose ( 2hPG ), hypoglycemia, time of glycemic control and dosage of insulin were measured and noted. Results After treatment, all FPG,2hPG and glycosylated hemoglobin( HbA1C ) were significantly lower than those before treatment ( P <0. 05 ). But there were no significant differences among the three groups in those indexes ( P > 0. 05 ). The incidence of hypoglycemia was less in group A than that of group C ( P <0. 05 ). The weight gain was less in group A than that of group B and group C ( P <0. 05 ). Conclusion Compared with insulin glargine group and novolin N group, insulin detemir group has similar efficacy but lower in the risk of hypoglycemia, less in the weight gain.