·糖尿病的胰岛素治疗·

　　杨颖 邓晨昕 高凌

　　作者单位：441021襄阳，湖北省襄阳市中心医院内分泌科

　　通讯作者：高凌，E-mail:gaoling321@sohu.com

　　【摘要】 目的 评估口服降糖药血糖控制不佳的T2DM患者联合地特胰岛素(Det)或中效胰岛素(NPH)治疗的有效性和安全性。 方法 80例血糖控制不佳的T2DM患者随机分为Det组和NPH组。在16周治疗期调整胰岛素剂量至FPG≤6.0 mmol/L。记录治疗前后FPG、HbA1c、低血糖事件及体重。 结果 治疗16周，两组FPG及HbA1c均较基线下降，差异无统计学意义。Det组的体重增加明显低于NPH组，且低血糖风险减少42%。 结论 相比NPH，Det在有效控制血糖的同时，能降低低血糖发生风险及减少体重增加。

　　【关键词】糖尿病;地特胰岛素;低精蛋白胰岛素

　　doi:10.3969/j.issn.1006-6187.2011.10.010

　　Efficacy and safety comparison of once-daily insulin detemir versus NPH insulin

　　treatment as add-on therapy to previous oral antidiabetic drugs in poorly controlled type 2 diabetes

　　YANG Ying，DENG Chen-xin，GAO Ling. Department of Endocrinology, Xiangyang Central Hospital, Hubei Xiangyang 441021, China

　　Corresponding author: GAO Ling,E-mail:gaoling321@sohu.com

　　【Abstract】 Objective To assess efficacy and safety of insulin detemir versus NPH insulin treatment as add-on therapy to previous oral antidiabetic therapy for type 2 diabetes. Methods80 Patients with type 2 diabetes inadequately controlled were randomized to addition of once-daily insulin detemir versus NPH insulin for 16 weeks. Insulin doses were titrated toward prebreakfast glucose targets ≤6.0mmol/L. Outcome measures included fasting blood glucose (FBG), HbA1c, events of hypoglycemia, and body weight. ResultAfter 16 weeks of treatment, FPG decreased from 9.90 to 6.89 mmol/L in insulin detemir and 10.01 to 6.78 mmol/L in insulin NPH,respectively (P>0.05). HbA1c decreased by 1.60% and 1.57% for detemir and NPH (P>0.05), respectively. Compared with NPH insulin, the events of all hypoglycemia in insulin detemir group was reduced by 42%. Mean weight gain was 2.59 kg in insulin detemir and 3.10 kg in NPH insulin (P<0.05). ConclusionInsulin detemir is as effective as NPH in glycemic control, but with reduced hypoglycemic events and less weight gain.

　　【Key words】Diabetes;Insulin detemir;NPH