【摘要】 目的 观察地特胰岛素或NPH联合诺和龙治疗对新诊断T2DM患者血糖水平及其变异性的影响。 方法 将100例新诊断T2DM病患者随机分为两组各50例，地特胰岛素联合诺和龙治疗(A)组与NPH联合诺和龙治疗(B)组。治疗3个月后，采用动态血糖监测(CGMS)系统进行连续72 h的血糖监测，监测数值864个。观察平均血糖水平、日内血糖最高值及最低值、血糖漂移最大幅度、血糖3.6～8.0 mmol/L所占一日内时间百分比(%)。 结果 (1)治疗3个月后两组FBG、PBG和HbA1c均降低，差异有统计学意义(P<0.05或0.01);而FBG、PBG和HbA1c水平两组间比较差异无统计学意义(P>0.05);(2)CGMS结果显示，两组间平均血糖水平差异无统计学意义[(7.2±1.4)vs(7.3±1.6)mmol/l，P>0.05]，但A组日内血糖最高值、日内血糖漂移最大幅度均低于B组[(9.2±2.0)vs(12.5±1.8)mmol/l，(5.8±1.6)vs(9.8±1.3)mmol/l]，A组患者血糖3.6～8.0 mmol/L所占一日内时间百分比高于B组患者[(82.4±6.5)%vs(73.1±9.4)%]，差异有统计学意义(P<0.01)。A组低血糖发生率低于B组(12%vs34%，P<0.05)。 结论 地特胰岛素在改善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

　　Effects of insulin Determir and NPH combined with Novonormin on glycemia variability of newly diagnosed T2DM patients SUN Xiao-shun. Department of Endocrinology, The Second Hospital of Jingzhou, Jingzhou 434000, China

　　【Abstract】 Objective To compare the effects of insulin Determir and NPH combined with Novonormin on glucose variability in newly diagnosed T2DM patients. Methods A total of 100 cases newly diagnosed T2DM were randomized into two groups with 50 in each: one group (group A, Determir group) was treated with insulin Determir combined with Novonormin and the other (group B, NPH group) with NPH combined with Novonormin. After 3 months\' treatment, the dynamic glycemia monitoring system(CGMS)was used for 72h glycemia monitoring and 864 numbers were recorded. The average glycemia levels, intraday highest and lowest glycemia, maximum amplitude of glycemic excursion, the average levels of pre- and post-prandial glycemia, and the percentage of glycemia drift accounted for intraday time were observed. Results (1). After 3 months\' treatment, the FBS, 2hPBG, and HbA1c of both groups had a significant decrease in statistics (P<0.05 or P<0.01), while the levels of FBS, 2hPBG, and HbA1c of the two groups in comparison were not statistically different (P>0.05). (2). The CGMS results showed that there was no significant difference in average glycemia levels between the two groups [(7.2±1.4) vs (7.3±1.6)mmol/l, P>0.05]. However, the intraday highest glycemia and maximum amplitude of glycemic excursion in the Determir group were lower than those in the NPH group [(9.2±2.0) vs (12.5±1.8)mmol/l, (5.8±1.6) vs (9.8±1.3)mmol/l]. The percentage of glycemia drift 3.6～8.0mmol/L accounted for the intraday time in the Determir group was significantly higher than that in the NPH group with a statistical difference (P<0.05). And the incidence of hypoglycemia in the Determir group was lower than that in the NPH group (12% vs 34%, P<0.05). Conclusion Insulin determir improves glycemia variability better than NPH.

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