甘精胰岛素联合口服二甲双胍与单纯胰岛素治疗老年糖尿病患者的疗效比较  

Comparison of curative effect of insulin glargine together with metformin and insulin in aged diabetes mellitus patients

作　　者：崔秀丽[1] 贾中骄[2] 刘庆君[3] 蔡春友[1] 肖广辉[4] 

机构地区：[1]天津医科大学基础医学研究中心内分泌与代谢病实验室,天津300070 [2]河北医科大学基础医学院解剖学教研室,河北石家庄050017 [3]天津医科大学第二医院老干部科,天津300211 [4]天津医科大学总医院干部病房,天津300052

出　　处：《临床荟萃》2011年第13期1134-1137,共4页Clinical Focus

摘　　要：目的观察在单纯口服药物血糖控制不良的老年糖尿病患者中使用3种不同的胰岛素治疗方案对血糖及血脂的疗效情况,为老年人更好地控制血糖提供依据。方法随机将168例患者分为诺和锐三餐前皮下注射加睡前甘精胰岛素皮下注射组(n=48)、诺和锐30早晚餐前皮下注射组(n=60)、甘精胰岛素皮下注射加口服二甲双胍组(n=60)。测定3组患者治疗前后空腹血糖(FBG)、餐后2小时血糖(2 hPG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C),并进行治疗前后及组间的比较。结果与治疗前比较3种方案均可有效地降低FBG、2 hPG、HbA1c、TC及LDL-C(P<0.05)。治疗后甘精胰岛素联合口服二甲双胍组效果优于早晚餐前皮下注射诺和锐30组,FBG(6.2±1.5)mmol/L vs(8.1±1.8)mmol/L(P<0.05)、2 hPG(8.1±1.4)mmol/L vs(9.9±2.1)mmol/L(P<0.05)、HbA1c(7.0±1.4)%vs(8.6±1.7)%(P<0.05);但与诺和锐三餐前皮下注射联合睡前甘精胰岛素皮下注射组疗效相仿(P>0.05)。3种方案治疗后TC、TG、HDL-C和LDL-C水平差异均无统计学意义(P>0.05)。结论甘精胰岛素联合二甲双胍治疗老年2型糖尿病,患者依从性好,能更好地降低HbA1c水平和血脂,稳定血糖。Objective To investigate three therapeutic schedules and choose the effective therapeutic schedule for the aged type 2 diabetes mellitus（T2DM）,especially those whose blood glucose did not reach the standard with oral anti-diabetic drugs.Methods 168 aged patients with T2DM were randomed into three groups,NovoRapid before three meals together with the insulin glargine（n=48）;NovoMix30 before breakfast and supper（n=60）;insulin glargine together with metformin（n=60）.Fasting blood-glucose（FBG）,2-h plasma glucose（2 hPG）,glycolated hemoglobin（HbA1c）,serum total cholesterol（TC）,triglyceride（TG）,high density lipoprotein cholesterol（HDL-C）,low density lipoprotein cholesterol（LDL-C） were detected and compared before and after treatment in three groups of aged patients with T2DM.Results The three therapeutic schedules were all effective in reducing FBG,2 hPG,HbA1c,TC and LDL-C（P〈0.05）.Insulin glargine together with metformin was more effective than hypodermic injection NovoMix30 before breakfast and supper：FBG（6.2±1.5） mmol/L vs（8.1±1.8） mmol/L（P〈0.05）,2 hPG（8.1±1.4） mmol/L vs（9.9±2.1） mmol/L（P〈0.05）,HbA1c（7.0±1.4） % vs（8.6±1.7）%（P〈0.05）;and the effect was similar with the hypodermic injection NovoRapid before three meals together with the insulin glargine used before sleep（P〈0.05）.In addition,there were no significant difference in TC,TG,HDL-C and LDL-C among three groups（P〉0.05）.Conclusion Insulin glargine together with metformin is more efficient in controling blood glucose,blood fat and HbA1c.It also increases the patients＇ compliance.

关 键 词：糖尿病 2型 胰岛素 二甲双胍 老年人 对比研究 

分 类 号：R587.1[医药卫生—内分泌]