地特胰岛素对2型糖尿病肥胖及非肥胖患者血糖及体重的影响

　　王晓丽 孙侃 常向云

　　·糖尿病的胰岛素治疗·

　　作者单位：832000石河子，新疆石河子大学医学院第一附属医院内分泌代谢科

　　通讯作者：常向云，E-mail:cxyshzdx@126.com

　　【摘要】 目的 观察地特胰岛素治疗24周对2型糖尿病(T2DM)肥胖及非肥胖患者血糖及体重的影响。 方法 选取既往未接受过胰岛素治疗的T2DM患者54例，根据BMI分为肥胖(Ob)组24例和非肥胖(NOb)组30例，检测治疗前后体重、FBG、HbA1c，计算BMI、胰岛素用量等。 结果 地特胰岛素治疗24周后，Ob组和NOb组FBG[(7.3±1.2) mmol/L、(6.7±1.5) mmol/L]、HbA1c[(7.3±0.9)%、(6.5±0.8)%]均较基线值{ FBG[(9.4±2.5) mmol/L、(8.1±1.7) mmol/L]、HbA1c[(8.2±1.1)%、(7.6±1.9)%]}明显下降(P<0.05);Ob组治疗前后BMI变化[(-1.51±1.10) kg/m2]与NOb组[(0.15±1.00) kg/m2]比较，差异有统计学意义(P<0.05)。 结论 地特胰岛素治疗可有效降低肥胖和非肥胖T2DM患者血糖，且无明显体重增加效应。

　　doi:10.3969/j.issn.1006-6187.2011.06.004

　　The effects of insulin detemir on blood glucose and body weight in obese and non-obese type 2 diabetic patients

　　WANG Xiao-li，SUN Kan, CHANG Xiang-yun. The First Affiliated Hospital, University of Shihezi School of Medicine, Xinjiang Shihezi 832000，China

　　Corresponding author: CHANG Xiang-yun, E-mail: cxyshzdx@126.com

　　【Abstract】 Objective To observe the effects of insulin detemir on blood glucose and body weight in obese and non-obese type 2 diabetic patients. Methods 54 T2DM patients never receiving insulin treatment were divided into 2 groups: obesity(BMI≥24 kg/m2,n=24) and non-obesity(BMI<24 kg/m2,n=30).The efficacy of insulin detemir treatment for 24 weeks was analyzed. Results FBG(mmol/L) was lower at 24-w of treatment in both Ob

　　(7.3±1.2 vs 9.4±2.5) and NOb (6.7±1.5 vs 8.1±1.7) than at baseline (all P<0.05). There was no significant difference in FBG decrement between Ob and NOb groups. HbA1c (%) was lower at 24-

　　w of treatment in both Ob (7.3±0.9 vs 8.2±1.1) and NOb (6.5±0.8 vs 7.6±1.9) group than at baseline (all P<0.05), but no significant difference in HbA1c decrement between Ob and NOb. BMI (kg/m2) showed no change (P>0.05) between baseline and 24-w of treatment group, but the BMI decrement was more in Ob than in NOb (1.51±1.10 vs 0.15±1.00) (P<0.05).Insulin dosage (U/kg) was more at

　　24-w of treatment in both Ob (0.23±0.15 vs 0.13±0.02) and NOb (0.19±0.06 vs 0.12±0.03) than at baseline (all P<0.05).

　　(P<0.05). Conclusion s Detemir can effectively control the glucose level in both obesity and non-obesity without weight gain.

　　【Key words】Diabetes mellitus, type 2; Obesity; Insulin detemir