#甘精胰岛素与预混胰岛素治疗2型糖尿病的疗效和安全性比较.doc

·12 · 中国医师进修杂志2006 年4 月第29 卷第4 期内科版　Chin J Postgrad Med ,April 2006 ,Vol. 29 ,No. 4A ·临床论著· 甘精胰岛素与预混胰岛素治疗2 型 糖尿病的疗效和安全性比较 周桂兰　李竞　毕会明　王芳 量少。 【关键词】　甘精胰岛素; 　预混胰岛素; 　2 型糖尿病　　 　　【摘要】　目的　在口服降糖药不能良好控制血糖的情况下,加用每日1 次甘精胰岛素或加用 每日2 次预混胰岛素治疗,比较这两种方案的疗效和低血糖的风险。方法　40 例用口服降糖药血 糖控制不良的2 型糖尿病患者随机分为甘精胰岛素组(简称甘精组) 和预混胰岛素组(诺和灵30R , 简称预混组),每组各20 例。所有患者在原有的口服降糖药不变的基础上,甘精组每晚10 时注射 甘精胰岛素1 次;预混组每日早晚餐前分别注射诺和灵30R 预混胰岛素。根据空腹血糖( FB G) 的 水平,每周调整胰岛素剂量,以FB G 小于5.6 mmol/L 为治疗目标,共治疗16 周。观察血糖控制和 低血糖发生情况。结果　治疗后两组的FB G 在4 周和16 周都明显下降,但甘精组的下降幅度明 显大于预混组,差异有统计学意义( P 0. 01) 。两组的糖化血红蛋白( HbA1c) 在16 周时也明显的 下降,甘精组的下降幅度稍优于预混组,但二者的差异无统计学意义( P 0. 05) 。到达终点时预混 组的胰岛素用量明显大于甘精组 混组(甘精组3 例,15 %; 预混组9 例,45%) ,χ2 =4.285, P 0. 05 。结论　单用口服降糖药不能较 好控制血糖时,加用每日1 次甘精胰岛素或加用每日2 次预混胰岛素进行治疗,均能达到明显的 降糖效果。甘精胰岛素与预混胰岛素相比,降低FB G 的效果更好,低血糖的发生率低,胰岛素的用 ,差异有统计学意义( P 0. 05) 。甘精组低血糖事件明显少于预 Comparison of eff icacy and safety in treatment of type 2 diabetic mellitus between glargine quaque and mixed insulin 　　ZHOU Gui -lan, LI Jing, BI Hui -ming, WANG Fang. Department of En2 docrinology , The People′sHospitalof WuhanUniversity,Wuhan 430060 , China 　　【Abstract 】　Objective 　To compare the efficacy and the risk of hypoglycemia of glargine quaque die and mixed insulin bis in die on the condition of controlling the blood glucose unsuccessfully with oral drugs. 　Methods 　Forty type 2 diabetes patients which could not control the blood glucose successfully with drugs were divided into two groups randomly:glargine group (20 cases) and mixed insulin group (20 cases) . Without any change of oral drugs , the patients in glargine group were injected with the glargine hypodermically once at 10 O’clock every night and the patients in mixed insulin group were in2 jected with the mixed insulin (Novolin 30R) hypodermically before the meal of morning and evening re2 spectively for 16 weeks. The doses of insulin were adjusted each week according to the level of fasting bloodglucose (FBG) reachingtheaimoflessthan5.6mmol/L. 　Results 　The FB