甘精胰岛素替换预混胰岛素的临床疗效及长期可行性研究  

Efficacy and long-term viability of insulin glargine switched from premixed insulin

作　　者：刘洪丽[1] 韩颖[1] 吴英凤[1] 郭红磊[2] 

机构地区：[1]天津市大港油田总医院普通内科,天津300280 [2]天津医科大学代谢病医院糖尿病科 卫生部激素与发育重点实验室,天津300070

出　　处：《临床荟萃》2014年第8期869-872,共4页Clinical Focus

摘　　要：目的探讨甘精胰岛素替换预混胰岛素方案的临床疗效及长期可行性。方法将43例入组患者的预混胰岛素替换为甘精胰岛素,并调整口服降糖药物(OAD)。分别于治疗的第2、4、8、16周对患者进行实验室检查,测量项目包括:血糖、血脂、体质量指数、糖化血红蛋白(HbA1c)、医疗费用及观察试验结束后患者继续使用甘精胰岛素的依从性。调查患者的生活质量。结果治疗16周后,患者的空腹血糖、餐后血糖、HbA1c分别下降了1.35mmol/L、1.91mmol/L、0.71%,胰岛素剂量减少11.33U/d,生活质量得到提高,OAD种类明显增加,医疗费用上涨235.6元/月(均P<0.05)。研究结束后的第12周随访显示,仅28.2%的患者继续选择甘精胰岛素治疗。结论甘精胰岛素替换预混胰岛素能有效降低血糖并减少低血糖事件发生风险,但医疗费用较高。Objective To investigate the clinical efficacy and long-term viability of insulin glargine switched from premixed insulin in type 2diabetic patients.Methods Forty-three subjects were screened from outpatients with premixed insulin switched to insulin glargine and oral antidiabetic drugs（OAD）.Respectively after treatment at 2,4,8,16 weeks,the patients implemented laboratory examinations,measures including blood glucose,lipids,body mass index,glycosylated hemoglobin（HbA1c）and medical expenses.The compliance of insulin glargine was evaluated at the fourth and twelfth week after the end of the study.The patients were evaluated for life quality.Results After treatment of 16 weeks,the level of fasting blood glucose,postprandial blood glucose and HbA1 c decreased 1.35mmol/L,1.91mmol/L,0.71%,separately;insulin dosage reduced 11.33U/d;The life quality of the patients improved;types of OAD increased significantly;medical expenses rose$235.6yuan per month（all P 0.05）Only 28.2% of the patients continued to use insulin glargine at the 12-weeks＇ follow-up after the intervention.Conclusion The glucose control after insulin glargine switched from premixed insulin showed obvious effect on diabetes control and reduced hypoglycemic events,while medical expenses are higher.

关 键 词：糖尿病 2型 胰岛素 医疗费用 

分 类 号：R587.1[医药卫生—内分泌]