甘精胰岛素与预混胰岛素联合瑞格列奈治疗2型糖尿病的疗效及安全性评价  

Evaluation on effects and safety of glargine or premixed insulin combined with repaglinide in treating type Ⅱ diabetes mellitus

作　　者：简树财 刘毅[1] 李明秀[1] 代光明[1] 汪洪[1] 

机构地区：[1]四川省遂宁市第一人民医院内分泌科,629000

出　　处：《检验医学与临床》2017年第11期1605-1607,1610,共4页Laboratory Medicine and Clinic

摘　　要：目的探讨甘精胰岛素或预混胰岛素联合瑞格列奈对2型糖尿病的疗效及安全性。方法选取2014年12月至2015年12月该院收诊治疗的86例2型糖尿病患者作为研究对象,按照随机数字表分为Ⅰ组43例和Ⅱ组43例。Ⅰ组给予甘精胰岛素,于睡前皮下注射,初始剂量12U/d,同时联合瑞格列奈胰岛素促泌剂诺和龙,餐前口服1mg;Ⅱ组给予预混胰岛素诺和锐30R初始剂量6U,分别于早、晚餐前30min皮下注射,联合瑞格列奈胰岛素促泌剂诺和龙,餐前口服1mg。两组患者每周监测1次餐前、餐后2h及睡前共7个时间点血糖,受试者根据血糖水平调整胰岛素剂量,调整范围2~4U。每月随访1次,连续随访6个月。结果治疗后两组患者空腹血糖(FBG)、餐后2h血糖(2hPBG)、糖化血红蛋白(HbA1c)均降低,治疗3个月、6个月Ⅰ组FBG、2hPBG、HbA1c水平与同时段Ⅱ组比较,差异有统计学意义(P<0.05);治疗后Ⅰ组心理、生理、依从性、社会关系及自身影响评分均低于Ⅱ组,差异有统计学意义(P<0.05);治疗后Ⅰ组症状性低血糖发生率、轻微低血糖发生率、夜间低血糖事件、低血糖昏迷及心脑血管事件发生情况明显低于Ⅱ组(P<0.05)。结论甘精胰岛素联合瑞格列奈对2型糖尿病的疗效显著,有效控制血糖水平,提高生活质量和依从性,安全可靠,值得临床推广应用。Objective To investigate the effect and safety of glargine or premixed insulin combined with repaglinide in treating type Ⅱ diabetes mellitus（T2DM）. Methods A total of 86 cases of T2DM treated in our hospital from December 2014 to December 2015 were selected as the research subjects and divided into the group I （43 cases） and group Ⅱ （39 cases） according to the random number table. The group I was given glargine （subcutaneous injection with an initial dose of 12 U/d before sleep） and simultane-ously combined with repaglinide insulin secretagogue novonorm （oral 1 mg before each mead）. The group ]I was given premixed in- sulin aspart 30 R （subcutaneous with an initial dose of 6 U at 30 rain before breakfast and dinner） and combined with repaglinide in- sulin secretagogue novonorm（oral 1 mg before each meal）. The blood glucose was monitored at 7 time points of before meal, past- prandial 2 h and before sleep in the two groups. Insulin dose was adjusted according to blood glucose level of the subjects, and the adjustment range was 2-4 U. All patients were followed up once a month and followed up lasted for 6 consecutive months. Results After treatment, the levels of fasting blood glucose（FPG）, 2 h PBG and glycosylated hemoglobin （HbAlc） in the two groups were all decreased, and the levels of FPG, 2 h PBG and HbAlc after 3-month,6-month treatment had statistical differences in the same time period between the group Ⅰ and Ⅱ （P〈0.05）; the scores of psychology, physiologiy, compliance, social relations and their own influence after treatment in the group Ⅰ were lower than those in the group Ⅱ （P〈0.05）; the symptomatic hypoglycemia incidence, mild hypoglycemia, nocturnal hypoglycemia event, hypoglycemic coma and cardiocerebrovascular events in the group Ⅰ were significantly lower than those in the group Ⅱ （P〈0.05）. Conclusion Glargine combined with repaglinide could obtain significant efficacy in treating T2DM, which could effectively control the blood

关 键 词：甘精胰岛素 预混胰岛素 2型糖尿病 

分 类 号：R587.1[医药卫生—内分泌]