·糖尿病的胰岛素治疗·

　　作者单位：116033大连市中心医院内分泌科

　　通讯作者：高政南，E-mail: gao2008@163.com

　　2型糖尿病口服药控制不佳起始胰岛素治疗的临床观察

　　刘明明 高政南 牛敏 李欣宇 李永航 冯秋霞 侯桂梅 罗兰 王冰 程丽静

　　【摘要】目的比较甘精胰岛素联合瑞格列奈与门冬胰岛素30控制血糖的有效性和安全性。方法51例T2DM患者进行动态血糖监测后随机分为两组：甘精胰岛素组(G组)和门冬胰岛素30组(A组)。12周后复查HbA1c和动态血糖监测。结果两组血糖均有所下降，G组HbA1c≤6.5%达标率[(35.7±20.6)%]高于A组[(28.0±13.2)%](P<0.05)。动态血糖监测：治疗后G、A两组日间平均血糖绝对差[(1.67±0.13) vs (2.89±0.20)mmol/L](P<0.05)，日内平均血糖波动幅度[(4.13±0.21) vs (6.26±0.30)mmol/L](P<0.05)。结论两组均可有效控制血糖，G组HbA1c≤6.5%达标率更高，血糖波动性更小。

　　【关键词】糖尿病，2型;甘精胰岛素;门冬胰岛素30;动态血糖监测

　　doi:10.3969/j.issn.1006-6187.2012.05.011

　　Clinical observation on starting insulin after failure of oral antidiabetic drugs in type 2 diabetes mellitusLIU Ming-ming, GAO Zheng-nan, NIU Min, et al. Dalian Municipal Central Hospital, Dalian 116033, China

　　Corresponding author: GAO Zheng-nan, E-mail: gao2008@163.com

　　【Abstract】ObjectiveTo compare the efficacy and safety between treatment with insulin glargine and insulin aspart 30 in combination with repaglinide in the plasma glucose control.MethodsFifty-one T2DM patients were randomized into 2 groups after continuous monitoring their plasma glucose with CGMS for 72 hours： the insulin glargine group (G group) and insulin aspart 30 group (A group). Twelve weeks later, reviewing their HbA1c and monitoring their plasma glucose with CGMS were performed again for observing the effect of treatment.ResultsThe plasma glucose of both groups was decreased. The rate of HbA1c ≤ 6.5% in the G group [(35.7±20.6)%] was higher than in the A group [(28.0±13.2)%], (P<0.05). In monitoring with CGMS after treatment, the absolute means of daily differences (MODD) of the 2 groups were [(1.67±0.13) vs (2.89±0.20)mmol/L] (P<0.05), and the mean amplitude of glucose excursions (MAGE) in the daytime of the 2 groups were [(4.13±0.21) vs (6.26±0.30)mmol/L] (P<0.05).ConclusionAlthough the plasma glucose of the 2 groups can be effectively controlled, the rate of HbA1c ≤ 6.5% in the G group is higher than that in the A group, and the glucose fluctuation is less in the G group than in the A group.

　　【Key words】 Diabetes mellitus, type 2; Insulin glargine; Insulin aspart 30; Continuous glucose monitoring system (CGMS)