预混胰岛素与甘精胰岛素联合口服降糖药治疗初诊2型糖尿病的疗效比较(1)
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[摘要] 目的：比较诺和灵30R与甘精胰岛素联合二甲双胍强化治疗初诊2型糖尿病(T2DM)的疗效。方法：80例初诊T2DM患者分为诺和灵30R组(A组，40例)和甘精胰岛素联合二甲双胍组(B组，40例)，疗程3个月。比较治疗前后两组血糖控制情况及胰岛B细胞功能。结果：治疗后两组空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1C)均显著下降(均P<0.01)，胰岛素抵抗指数(HOMA-IR)下降(P<0.05)，胰岛素分泌指数(HOMA-β)升高(P<0.01)。B组血糖达标更迅速。A组较B组低血糖发生率更高。结论：甘精胰岛素联合二甲双胍治疗初诊2型糖尿病安全有效。
[关键词] 胰岛素；2型糖尿病；初诊；强化治疗
[中图分类号] R587.1[文献标识码]B [文章编号]1673-7210(2010)10(b)-050-02
Comparison of therapeutic effect of premixed insulin and insulin glargine plus oral hypoglycemic agents in newly diagnosed type 2 diabetics
ZENG Huafeng, LIU Zongxue, LI Ping, YU Hongli
(Deparment of Endocrinology, Shayang People′s Hospital of Jingmen City, Hubei Province, Jingmen 448200, China)
[Abstract] Objective: To compare the effects of premixed Novolin 30R insulin and insulin glargine plus Metformin in newly diagnosed type 2 diabetes (T2DM). Methods: 80 cases of newly diagnosed T2DM were divided into two groups, insulin Novolin 30R group (group A, n=40) and insulin glargine plus Metformin group (group B, n=40). The course of treatment was 3 months.The glucose improvement and islet B-cell function were compared before and after treatment. Results: After treatment, FPG, 2 hPG, HbAlc were significantly decreasedin each group (all P<0.01). HOMA-β were increased (P<0.01) and Homa-IR were decreased(P<0.05) in each group. The time of achieving optimal glycemic level was shorter in group B. In group A, the incidence rate of hypoglycemia was higher than group B. Conclusion: Insulin glargine plus Metformin in the treatment of newly diagnosed type 2 diabetes is effective and safe.
[Key words] Insulin; Type 2 Diabetes; Newly diagnosed; Intensive control
预混胰岛素因兼顾基础及餐时血糖的控制在临床上广泛应用，但也有其不足之处，部分患者在接受预混胰岛素治疗后，频发低血糖事件。《中国2型糖尿病防治指南》2007年版指出，理想的胰岛素治疗应接近生理性胰岛素分泌模式。理想的基础胰岛素作用应能覆盖24 h，无明显的峰值，避免空腹和餐前低血糖。本研究比较了预混胰岛素诺和灵30R和甘精胰岛素联合二甲双胍治疗T2DM的疗效，现报道如下:
1 对象与方法
1.1 研究对象
选择2009年2～12月我院住院的初诊T2DM患者80例，符合1999年WHO的诊断标准。年龄35～60岁，既往未用任何降糖药物治疗，除外严重的心、肝、肾功能不全 ......
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