糖尿病的胰岛素治疗

　　应用动态血糖监测系统评价地特胰岛素作为基础胰岛素治疗的优越性

　　牛晓红 孙衍 周瑞君 李莉 宋祺 司芹芹 金苗苗 李俊岩

　　【摘要】 目的 采用动态血糖监测(CGMS)系统观察口服降糖药控制不佳的T2DM患者加用地特胰岛素治疗的优越性。 方法 68例使用口服降糖药血糖控制不佳的T2DM患者，按1：1随机分为睡前加用地特胰岛素组(Det组)和中性鱼精蛋白锌胰岛素组(NPH组)，治疗12周。 结果 治疗12周后，两组HbA1c、FPG均较基线下降，但两组间差异无统计学意义(P>0.05)。Det组血糖值标准差、 FPG标准差、睡前血糖标准差、日间血糖平均绝对差均明显低于NPH组(P

　　【关键词】糖尿病，2型;地特胰岛素;动态血糖监测

　　Superiority of detemir as basal insulin replacement evaluated by continuous glucose monitoring system NIU Xiao-hong, SUN Yan, ZHOU Rui-jun, et al. Department of Endocrinology, Heji Hospital Affiliated to Changzhi Medical College, Shanxi 046000, China

　　【Abstract】 Objective To evaluate the superiority of detemir as basal insulin replacement by continuous glucose monitoring system (CGMS) in T2DM patients. Methods Six-eight T2DM patients who had poorly controlled blood glucose by oral hypoglycemic were randomized into the insulin detemir (Det)group (n=34) and neutral protamine hagedorn (NPH) group (n=34). They were treated once daily at bedtime for 12 weeks. Results After twelve weeks, the HbAlc and FPG were decreased in both groups, but there was no statistical difference in the comparison between the two groups (P>0.05). In the Det group, the standard deviation (SD) of blood glucose, SD of FPG,SD of blood glucose at bedtime，and absolute means of daily differences (MODD) were significantly lower than those in the NPH group respectively (P<0.05; P<0.01). The incidence of hypoglycemia episode in the Det group was 11.8%, significantly lower than 23.5% in the NPH group (P<0.05). Conclusions The treatment with detemir as basal insulin replacement is superior to NPH in glycemia and HbA1c control, and proved by CGMS, with less daytime glucose fluctuation and hypoglycemia episode in the T2DM patients with poorly controlled glucose by oral anti-hyperglycemic agents.

　　【Key words】 Diabetes, type 2; Insulin detemir; Continuous glucose monitoring