地特胰岛素与甘精胰岛素治疗2型糖尿病患者的临床疗效比较  

Comparison of therapeutic effect of insulin detemir and insulin glargine for type 2 diabetes mellitus

作　　者：张彦彬[1] 张耀芬[2] 

机构地区：[1]海军总医院内分泌科,北京100048 [2]武警总医院干部病房三科,北京100039

出　　处：《临床荟萃》2011年第24期2130-2131,2136,共3页Clinical Focus

摘　　要：目的比较口服降糖药(OAD)控制不佳的2型糖尿病(T2DM)患者加用1天1次地特胰岛素或甘精胰岛素治疗后对血糖的影响。方法共入选40例T2DM患者,随机给予睡前注射地特胰岛素或甘精胰岛素治疗。治疗时间为12周,比较两组治疗前后空腹血糖(FPG)、糖化血红蛋白(HbA1c)、体质量的变化及低血糖的发生。结果治疗12周时与治疗前比较,地特胰岛素组和甘精胰岛素组的HbA1c和FPG均有明显下降(P<0.01),FPG分别由11.41mmol/L和11.36mmol/L降至6.31mmol/L和6.54mmol/L,HbA1c分别由8.75%和9.17%降至7.41%和7.76%;治疗前后两组间差异无统计学意义。治疗前后地特胰岛素组和甘精胰岛素组的体质量增加分别为(-1.30±1.82)kg和(2.20±2.84)kg(P<0.05)。两组各发生1例低血糖,发生率均为5.0%。结论 OAD治疗不佳的T2DM患者,联合地特胰岛素或甘精胰岛素治疗,具有相似的血糖控制,但地特胰岛素组体质量增加少。Objective To compare efficacy,safety and change in body mass after once-daily insulin detemir or insulin glargine added to oral antidiabetic drugs（OAD） in poorly controlled type 2 diabetes mellitus（T2DM） patients. Methods 40 T2DM patients with poor glycemic control by oral antidiabetic drugs were randomized into two groups, which were treated with detemir＋OAD and glargine ＋ OAD for 12 weeks, respectively. The parameters measured before and after treatment included fasting plasma glucose（FPG）,human glycated hemoglobin A1c（ HbA1 c） and body mass. Hypoglycemia was also noted. Results At week 12 after treatment, HbALc and FPG were both significantly decreased than before treatment（ P〈0.01）. HbA1c decreased from 8.75 % to 7.41% in detemir ＋ OAD group and from 9.17% to 7.76% in glargine＋ OAD group, respectively, while FPG decreased from 11.41 mmol/L to 6.31 mmol/L in detemir＋ OAD group and from 11.36 mmol/L to 6.54 mmol/L in glargine＋ OAD group, respectively（ P 0.05）. No significant difference was found in HbA~ c and FPG before and after treatment between two groups. The average body mass gain respectively in detemir＋ OAD group and glargine＋ OAD group was （- 1.30 ±1.82） kg and （2.20±2.84） kg（P 〈0.05）. The incidence of hypoglycemia was similar between two groups （5.0% vs 5.0%）. Conclusion The effect of detemir ＋ OAD and glargine-t-OAD on blood glucose in patients with poorly controlled T2DM is similar. However,detemir＋OAD is advantageous over glargine＋OAD in control of body mass gain.

关 键 词：糖尿病 2型 胰岛素 长效 体重变化 血红蛋白A 糖基化 

分 类 号：R587.1[医药卫生—内分泌]