·糖尿病胰岛素治疗·

　　【摘要】 目的 评价地特胰岛素(Det)联合瑞格列奈对老年T2DM患者的疗效及安全性。 方法 60例老年T2DM患者分为Det联合瑞格列奈组(A组)和预混胰岛素组(B组)进行治疗，观察治疗前后的FBG、2 hBG、HbA1c、BMI、血糖波动及低血糖的频率、程度等情况。 结果 两组FBG、2 hBG、HbA1c明显下降(P<0.05)，A组低血糖发生率、程度及血糖漂移度均低于B组(P<0.05);A组体重下降0.49 kg，B组体重增加1.48 kg，差异均无统计学意义(P>0.05)。 结论 地特胰岛素联合瑞格列奈可显著降低老年T2DM患者血糖，低血糖发生率低，安全性高。

　　【关键词】糖尿病，2型;地特胰岛素;瑞格列奈

Efficacy and safety of insulin detemir combined with repaglinide for the elderly T2DM patients ZHAO Yong-cai, LI Xin-sheng, ZHANG Jin-cheng. Department of Endocrinology, Cangzhou Central Hospital, Cangzhou 061001, China

　　【Abstract】 Objective To evaluate the efficacy and safety of insulin detemir combined with repaglinide for the treatment of elderly T2DM patients. Methods All the 60 elderly T2DM inpatients were divided into the insulin detemir + repaglinide group (Group A) and premixed human insulin 30R group (Group B). The observation on the changes in the levels of FBG, 2 hBG, HbA1c, BMI, glucose excursion, and the incidence and severity of hypoglycemia events of the two groups was done for evaluation. Results After the treatment for 12 weeks, the levels of FPG, 2 hBG, and HbA1c decreased significantly from baseline in both groups (P<0.05). Compared with Group B, the incidence and severity of hypoglycemia events as well as glucose excursion in Group A were all lower (P<0.05). In Group A, the body weight was 0.49kg decreased, while it was 1.48kg increased in Group B, and the difference in each group was not statistically significant compared with pretreatment (P>0.05). Conclusions For the elderlyT2DM inpatients, the treatment with insulin detemir + repaglinide improves the glucose control significantly with a lower incidence of hypoglycemia events and a good safety.

　　【Key words】Diabetes mellitus, type 2; Insulin detemir; Repaglinide; Hypoglycemia