地特胰岛素加三餐前速效胰岛素与胰岛素泵短期强化治疗对2型糖尿病的疗效比较  

Comparison of the efficacy between basal insulin detemir with pre-meal insulin aspart and continuous subcutaneous insulin infusion(CSⅡ) in type 2 diabetes

作　　者：邢莉[1] 申虎威[1] 

机构地区：[1]长治医学院附属和平医院内分泌科,山西长治046000

出　　处：《中国糖尿病杂志》2012年第2期126-128,共3页Chinese Journal of Diabetes

摘　　要：目的对比基础—餐时胰岛素与胰岛素泵在T2DM治疗中的有效性和安全性。方法将68例T2DM患者随机分为两组,A组采用三餐前门冬胰岛素联合睡前地特胰岛素治疗,B组采用胰岛素泵(使用门冬胰岛素)降糖治疗。治疗3个月后对比两组血糖控制情况、血糖达标所需要的时间、胰岛素用量、低血糖发生率等情况。结果两组治疗后HbA1c、FPG、2hPG均较治疗前显著下降(P<0.01),而FC-P、2hC-P均较治疗前明显升高(P<0.01)。上述指标两组之间无统计学差异(P>0.05)。两组血糖达标时间、日治疗剂量及低血糖发生率均无统计学差异(P>0.05),但A组的日治疗费用明显低于B组(P<0.05)。结论地特胰岛素联合三餐前门冬胰岛素强化治疗能有效模拟人生理胰岛素分泌,有效控制高血糖,且效价比优于胰岛素泵强化治疗。Objective To compare the efficacy and safety between insulin aspart combined with insulin detemir and insulin pump in the intensified therapy of patients with type 2 diabetes mellitus（T2DM）. Methods 68 patients with T2DM were randomly divided into two groups.The patients in group A were given insulin aspart combined with insulin detemir,and the patients in group B received insulin pump therapy with insulin aspart.Time to target glucose,insulin dosage and hypoglycaemia incidence before and after 3 months′therapy were measured and compared in both groups. Results After 3 month′s therapy,the HbA1c（%） levels significantly decreased in both groups[group A：（10.1±0.2） vs（7.2± 0.1）;group B：（10.2± 0.3） vs（7.1± 0.2）,P〈0.01].The blood C-peptide levels in both groups significantly increased after treatment [group A：（1.23±0.54） vs（2.96±0.92） mmol/L;group B：（1.27±0.62） vs（3.02±0.87） mmol/L;P〈0.01].The average time to target glucose,the insulin dosage and hypoglycemia incidence[group A vs group B：（0.67±0.41） vs（0.65±0.47） time/person] showed no significant difference between two groups（P〈0.05）,but hospitalization cost was obviously lower in group A than group B[（19.71±2.03） vs（39.83±6.23） $/d,P〈0.05].Conclusion Insulin detemir combined with pre-meals insulin aspart could imitate the physiological insulin secretion and control the hyperglycemia effectively with reduced hypoglycemia risk and less cost of hospitalization.

关 键 词：地特胰岛素 门冬胰岛素 胰岛素泵 糖尿病 2型 

分 类 号：R587.1[医药卫生—内分泌]