地特胰岛素治疗老年2型糖尿病患者的疗效评价  

Aclinical use of insulin determir in the elderly with type 2 diabetes

作　　者：谢崇凡[1] 周海川[1] 

机构地区：[1]重庆市梁平县人民医院内分泌科,重庆梁平405211

出　　处：《实用临床医药杂志》2013年第14期89-91,共3页Journal of Clinical Medicine in Practice

摘　　要：目的比较口服降糖药(OAD)血糖控制不佳的老年T2DM患者加用地特胰岛素、甘精胰岛素或中性鱼精蛋白锌胰岛素(NPH)的疗效和安全性。方法将130例OAD血糖控制不佳的老年T2DM患者随机分为观察组和对照组。观察组给予地特胰岛素治疗,对照组给予甘精胰岛素治疗。治疗12周后评价2组患者的临床疗效。结果 2组治疗后FBG、2hPG、HbA1C水平均较同组治疗前明显降低(P<0.05),但观察组与对照组比较差异无统计学意义(P>0.05);观察组体质量指数(BMI)低于对照组,差异有统计学意义(P<0.05);观察组治疗期间低血糖发生率为3.1%,明显低于对照组的13.9%,差异有统计学意义(P<0.05)。结论 OAD血糖控制不佳的老年T2DM患者加用地特胰岛素、甘精胰岛素或NPH均可有效控制血糖,但地特胰岛素在减少体质量增加及降低低血糖发生率上更有优势。Objective To compare the efficacy and safety among bedtime-daily detemir,glargine and neutral protamine hagedorn（NPH）in poorly controlled elderly type 2 diabetes with oral antidiabetic drugs（OAD）.Methods One hundred and thirty elderly T2DM patients were randomly divided into two groups.The observation group received insulin determir therapy and the control group received NPH.After 12-week treatment,the clinical efficacy of the two groups was observed.Results The levels of FBG,2 HPG,HbA1C of the observation group after treatment significantly decreased compared with that before treatment （P ＜ 0.05）,but there was no statistically significant difference compared with the control group （P ＞0.05）.The BMI increase of the observation group was less than that of the control group,and the difference between groups was statistically significant （P ＜ 0.05）.The incidence （3.1％） of hypoglycemia of the observation group was less than that （13.9 ％） of the control group （P ＜ 0.05）.Conclusion Adding giargine,detemir and NPH to OAD in poorly controlled T2DM patients could control the glycemia effectively,but detemir can achieve benefit from reducing weight gaining and the incidence of hypoglycemia.

关 键 词：2型糖尿病 地特胰岛素 甘精胰岛素 中性鱼精蛋白锌胰岛素 

分 类 号：R587.1[医药卫生—内分泌]