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地特胰岛素联合门冬胰岛素强化治疗2型糖尿病疗效观察

来自:中国糖尿病资讯网  编辑:editor|点击数:|2012-11-26

  ·糖尿病胰岛素治疗·

  地特胰岛素联合门冬胰岛素强化治疗2型糖尿病疗效观察

  李文华 林梅 刘永健

  【摘要】 目的 观察口服降糖药(OAD)血糖控制不佳的T2DM患者,分别采用地特胰岛素联合三餐前门冬胰岛素和胰岛素泵强化治疗的有效性、安全性及性价比。 方法 126例T2DM患者随机分为地特胰岛素联合门冬胰岛素组(Det+Asp组)和胰岛素泵组(CSII组),治疗两周。 结果 两周后,两组FBG、2 hBG、TG、TC和HOMA-IR较治疗前明显下降, FC-P、2 hC-P和HOMA-β较治疗前明显升高(P均<0.05);血糖达标时间Det+Asp组稍长,但两组差异无统计学意义(P>0.05);两组低血糖发生率均为3.2%;Det+Asp组胰岛素用量更大,但治疗费用明显低于CSII组,差异有统计学意义(P<0.05或P<0.01)。 结论 地特胰岛素联合门冬胰岛素能模拟人生理性胰岛素分泌,改善T2DM患者的胰岛β细胞功能,疗效及安全性与胰岛素泵相当,但前者性价比更高。

  【关键词】糖尿病,2型;地特胰岛素;胰岛素泵;强化治疗

  Effect of intensive therapy with insulin detemir plus pre-meal insulin aspart on T2DM  LI Wen-hua, LIN Mei, LIU Yong-jian. Department of Endocrinology, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

  【Abstract】 Objective To observe the effect and safety of intensive therapy with insulin detemir plus pre-meal aspart insulin for poorly-controlled T2DM patients with oral anti-diabetic drugs (OAD) and to compare with the result of continuous subcutaneous insulin infusion (CSII) treatment. Methods One hundred and twenty-six T2DM patients were randomized into insulin detemir plus pre-meal aspart insulin group (Det+Asp group) and CSII group and they were treated for two weeks respectively. Results After the treatment, the levels of FBG, 2 hBG, TG, TC, and HOMA-IR in both groups were significantly decreased, while the levels of FC-P, 2 hC-P, and HOMA-β were markedly increased (all P<0.05), however, there was no statistical difference between the two groups (P>0.05). The time for blood glucose to the target level in the Det+Asp group was slightly longer than that in the CSII group, but without significant difference between them (P>0.05). The hypoglycemic incidence was 3.2%, same in both groups. Although the insulin dose in the Det+Asp group was increased, the cost of hospitalization was significantly lower than that in the CSII group, and the difference between the two groups was statistically significant (P<0.05 or P<0.01). Conclusions Insulin detemir plus pre-meals insulin aspart treatment can control hyperglycemia effectively by imitating the physiological insulin secretion, improve the function of β-cells, and reduce insulin resistance, having a similar efficacy and safety but a lower cost compared with CSII.

  【Key words】Diabetes mellitus, type 2; Insulin detemir; Insulin pump; Continuous subcutaneous insulin infusion (CSII); Intensive therapy

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