两种胰岛素类似物治疗2型糖尿病的比较  

Comparison of premix and basal insulin premix analogue therapy in type 2 diabetes mellitus patients

作　　者：王丽云[1] 谢伯欣[1] 王铮[1] 王翔[1] 张操[1] 宗俊杰[1] 

机构地区：[1]江苏大学附属宜兴医院内分泌科,江苏宜兴214200

出　　处：《临床荟萃》2011年第20期1749-1751,共3页Clinical Focus

摘　　要：目的探讨预混胰岛素类似物门冬胰岛素30注射液(诺和锐30)和长效胰岛素类似物甘精胰岛素注射液(来得时)治疗2型糖尿病的疗效和安全性。方法 83例初诊2型糖尿病随机分成2组,分别给予诺和锐30每天2次及来得时每天1次治疗12周,观察治疗前后空腹血糖(FPG)、餐后2小时血糖(PPG)、糖化血红蛋白(HbA1c)的变化,比较两组血糖达标率、低血糖的发生率。结果诺和锐30组HbA1c较来得时治疗组明显下降,HbA1c(7.42±1.38)%vs(8.31±1.82)%(P<0.05)。诺和锐30组PPG显著低于来得时组,(7.82±4.18)mmol/L vs(8.21±3.90)mmol/L(P<0.05)。诺和锐30组PPG达标率更高,83.0%vs 56.1%(P<0.05),达标时间更短,(7.85±1.48)天vs(8.25±2.46)天,但低血糖事件较来得时组略高,26.2%vs 12.2%(P<0.05)。诺和锐30组胰岛素用量高于来得时组,(0.61±0.24)U/kg vs(0.50±0.27)U/kg(P<0.05),体质量增加也较明显,(5.6±4.6)kg vs(3.0±4.3)kg(P<0.05)。结论诺和锐30每天2次治疗比来得时每天1次治疗能更有效地降低血糖,血糖达标时间更短,但低血糖发生率略高。Objective To compare the efficacy and safety of biphasic insulin aspart 30（BIAsp30） given twice daily with once-daily insulin glargine in type 2 diabetes mellitus. Methods 83 patients with newly diagnosed type 2 diabetes mellitus were randomized to receive either aspart 30 twice daily or glargine once daily for 12 weeks.The level of fasting plasma glucose（FPG）,2 hour postprandial glucose（PPG）,glycosylated hemoglobin A1c（HbA1c） were compared before and after treatment.At the end of the trial,the difference in the proportion of patients who reached a target of FPG7.0 mmol/L and PPG10.0 mmol/L was observed.Hypoglycemic episodes were recorded. Results HbA1c change was significantly greater in BIAsp 30 group than glargine group,（7.42±1.38）% vs（8.31±1.82）%（P0.05）.PPG was significantly lower for BIAsp 30 compared with glargine group,（7.82±4.18） mmol/L vs（8.21±3.90） mmol/L（P0.05）.At the end of the trial,more patients using BIAsp 30 reached a target of PPG10.0 mmol/L,83.3% vs 56.1%（P0.05）.26.2% and 12.2% of patients experienced minor hypoglycemic episodes in BIAsp 30 and glargine groups,respectively（P0.05）.At the end of the trial,mean daily insulin doses were（0.61±0.24） U/kg vs（0.50±0.27） U/kg in BIAsp 30 and glargine groups,respectively（P0.05）.Body mass gain with BIAsp 30 was more than with glargine,（5.6±4.6） kg vs（3.0±4.3）kg（P0.05）. Conclusion BIAsp 30,given twice daily was more effective than insulin glargine,given once daily in patients with type 2 diabetes mellitus,but was associated with increased minor hypoglycemic and body mass gain.

关 键 词：糖尿病 2型 胰岛素 双时相门冬胰岛素 甘精胰岛素 

分 类 号：R587.1[医药卫生—内分泌]