·糖尿病的胰岛素治疗·

　　汪英 袁莉 万青 邓秀玲 黎慧清 周愍

　　作者单位：430022武汉，华中科技大学附属协和医院内分泌科

　　通讯作者：袁莉，E-mail：yuanli18cn@yahoo.com.cn

　　【摘要】目的比较地特胰岛素(Det)和中性精蛋白锌胰岛素(NPH)对口服降糖药控制不佳的T2DM患者血糖水平及其变异性的影响。方法32例口服降糖药(OAD)控制不佳(HbA1c>7.5%)的T2DM患者随机分为两组，分别加用Det和NPH胰岛素治疗，治疗12周后，动态血糖监测系统(CGMS)进行连续72h的血糖监测。结果(1)两组患者治疗12周后FBG、2hBG和HbA1c水平均较治疗前明显降低(P<0.01);而在治疗前后两组间FBG、2hBG和HbA1c均无统计学差异;(2)CGMS结果显示,两组间平均血糖水平差异无统计学意义(P>0.05)，但Det组日内血糖最高值、日内血糖漂移最大幅度均明显低于NPH组(P<0.01)。结论Det在改善T2DM患者血糖变异性方面优于NPH。

　　【关键词】糖尿病，2型;地特胰岛素;动态血糖监测;血糖变异性

　　doi:10.3969/j.issn.1006-6187.2012.03.012

　　Comparison of effects of insulin determir versus NPH treatment on blood glucose variability in poorly controlled type 2 diabetesWANG Ying, YUAN Li, LI Guang-li,et al.Department Endocrinology of Union Hospital in Tongji College, Huazhong University of Science and Technology

　　Corresponding author: YUAN Li, E-mail：yuanli18cn@yahoo.com.cn

　　【Abstract】ObjectiveTo investigate the effects of insulin determir and NPH treatment on glucose variability in type 2 diabetes.MethodsThirty-two patients with poorly controlled type 2 diabetes were randomly divided into two groups to receive insulin determir and NPH insulin therapy, respectively. After 12 weeks’ treatment, the continuous glucose monitoring system(CGMS)was used for 72h.ResultsFPG, 2hPG and HbA1c decreased in all patients after 12 weeks’ treatment(P<0.01),but there was no significant difference between two groups. According to CGMS, there was no significant difference in average glycemic level of both groups(P>0.05). The intraday highest glucose and amplitude peak of glucose drift were obviously lower in determir group than in NPH group, and the percentage of glucose drift between 3.9 and 10.0mmol/L was significantly higher in determir group than in NPH group (P<0.05).ConclusionInsulin determir may improve glucose variability with a better advantage than NPH.

　　【Key words】Diabetes mellitus, type 2;Insulin determir; Dynamic blood glucose monitoring;Glycemic variability