中效胰岛素治疗2型糖尿病疗效观察  

Observation of curative effect by isophane insulin in the treatment of type 2 diabetes mellitus

作　　者：李永新 刘兰梅 黄燕丽 

机构地区：[1]广州市白云区三元里街社区卫生服务中心,510405

出　　处：《中国实用医药》2015年第17期22-23,共2页China Practical Medicine

摘　　要：目的观察睡前注射一次中效胰岛素治疗2型糖尿病的效果,监测低血糖的风险及不良反应的发生情况,了解此治疗方案的疗效及安全性。方法选择本社区42例口服降糖药物而血糖控制不达标的2型糖尿病患者,在口服降糖药的基础上,按自愿的原则分为两组,中效胰岛素(NPH)组(18例):原有的口服药物不变,睡前加用中效胰岛素皮下注射治疗;口服药物组(24例):采用增加口服药物剂量方法 ,逐步增加降糖药物的剂量,达到最大范围。以两组空腹血糖(FBG)均达到≤7.0 mmol/L为目标,共治疗6个月,观察两组血糖控制情况、低血糖事件及其他药物不良反应的发生情况。结果治疗后两组全天血糖谱及糖化血红蛋白(Hb A1c)均较基线水平有所下降,但NPH组下降比口服药物组更显著,两组下降幅度比较,差异具有统计学意义(P<0.05)。低血糖方面,两组各发生1例仅有症状的低血糖事件。不良反应方面,药物治疗组胃肠道反应较NPH组明显增高,差异具有统计学意义(8/24,0/18,P<0.01)。结论睡前注射一次中效胰岛素联合口服降糖药物方案治疗血糖控制不理想的2型糖尿病患者,疗效好,容易被患者接受,值得在社区推广。Objective To observe the effect of isophane insulin injection before sleep in the treatment of type 2 diabetes mellitus, to monitoring risk of hypoglycemia and incidence of adverse reactions, and to understand the curative effect and safety of this treatment regimen. Methods There were 42 type 2 diabetes mellitus patients with substandard blood glucose level by oral antidiabetic drugs. They were voluntarily divided into two groups. Isophane insulin（NPH） group（18 cases） received subcutaneous injection of isophane insulin before sleep in addition to oral administration. Oral administration group（24 cases） received increased dose of oral administration by gradual increase to maximum range. Treatment lasted for 6 months, aiming at fasting blood glucose（FBG） ≤7.0 mmol/L in both groups. Blood glucose control, hypoglycemia events, and other adverse reactions were observed in the two groups. Results After treatment, both groups had decreased blood glucose profile and glycosylated hemoglobin（Hb A1c） level than the baseline level, and NPH group had much obvious decreased level than oral administration group. The difference of decreased level between the two groups had statistical significance（P〈0.05）. Each group had 1 case of hypoglycemia event with symptoms. Oral administration group had higher gastrointestinal reactions as adverse reactions than NPH group, and their difference had statistical significance（8/24, 0/18, P〈0.01）. Conclusion Isophane insulin injection before sleep combined with oral administration of antidiabetic drugs can provide good effect in controlling 2 diabetes mellitus patients with unsatisfactory blood glucose control. This method can be easily acceptable for patients, and it is worth promotion in community.

关 键 词：中效胰岛素 联合治疗 2型糖尿病 

分 类 号：R587.1[医药卫生—内分泌]