甘精胰岛素分别联合赖脯胰岛素与门冬胰岛素治疗2型糖尿病的疗效及对血糖波动、血糖漂移的影响  

Comparison of the curative effect of insulin glargine combined with insulin lispro and combined with insulin aspart on T2DM and corresponding influence on blood glucose fluctuation and blood glucose excursion

作　　者：朱海平[1] Zhu Haiping(Department of Internal Medicine,the People＇s Hospital of Huozhou,Huozhou 031400,China)

机构地区：[1]山西省霍州市人民医院内科,031400

出　　处：《中国实用医刊》2018年第21期103-106,共4页Chinese Journal of Practical Medicine

摘　　要：目的 比较甘精胰岛素分别联合赖脯胰岛素与门冬胰岛素治疗2型糖尿病（T2DM）的疗效及对血糖波动、血糖漂移的影响.方法 选取霍州市人民医院2015年7月至2017年7月收治的2型糖尿病患者70例,按入院顺序随机分为观察组（n=35）和对照组（n=35）,观察组采用甘精胰岛素联合赖脯胰岛素治疗,对照组采用甘精胰岛素联合门冬胰岛素治疗,治疗后12周比较两组空腹血糖（FBG）、餐后2 h血糖（2 h PG）、糖化血红蛋白（HbA1c）、空腹胰岛素（Fins）分泌水平、胰岛β-细胞功能指数（HOMA-β）、胰岛素抵抗指数（HOMA-IR）及治疗总有效率,并计算两组平均血糖水平、血糖漂移度、血糖漂移系数、血糖达标时间、血糖达标所需日均胰岛素量及低血糖发生率.结果 治疗后12周,观察组疗效显著高于对照组（P〈0.05）,平均血糖水平、血糖漂移幅度、血糖漂移系数及低血糖发生率均低于对照组（P均〈0.05）,且血糖达标时间及血糖达标所需日均胰岛素含量少于对照组（P均〈0.01）;治疗前,两组FBG、2 h PG、HbA1c、Fins及HOMA-β、HOMA-IR比较差异均未见统计学意义（P均〉0.05）,治疗后两组Fins及HOMA-β显著升高,FBG、2 h PG、HbA1c及HOMA-IR降低,且观察组上述变化更明显（P均〈0.05）.结论 甘精胰岛素联合赖脯胰岛素治疗T2DM较甘精胰岛素联合门冬胰岛素更能有效控制血糖波动,减小血糖漂移度,并降低低血糖发生率,控制血糖效果更好.Objective To compare the curative effect of insulin glargine combined with insulin lispro and combined with insulin aspart on type 2 diabetes mellitus （ T2 DM ） , and study the corresponding influence on blood glucose fluctuation and blood glucose excursion .Methods A total of 70 patients with T2DM who were hospitalized in the People＇s Hospital of Huozhou from July 2015 to July 2017 were randomly divided into observation group （ n=35 ） and control group （ n=35 ） according to their order of admission .Patients in observation group were treated with insulin glargine combined with insulin lispro , and patients in control group were treated with insulin glargine combined with insulin aspart.Levels of fast blood glucose （FBG）, 2-hour postprandial blood glucose （2 h PG）, glycosylated hemoglobin （HbA1c）, fasting insulin （Fins） secretion, isletβ-cell function index （HOMA-β）, insulin resistance index （ HOMA-IR） and total treatment response rate were compared between the two groups 12 weeks after treatment .The average blood glucose level , amplitude of blood glucose excursion , blood glucose excursion coefficient , time of reaching target of blood glucose , daily amount of insulin for reaching target of blood glucose and the incidence of hypoglycemia of the two groups were calculated . Results The curative effect was significantly better in observation group than control group 12 weeks after treatment （ P〈0.05 ） .The average blood glucose level , amplitude of blood glucose excursion , blood glucose excursion coefficient and the incidence of hypoglycemia in observation group were＆nbsp;significantly lower than those in control group （ all P〈0.05 ） , and the time of reaching target of blood glucose and daily amount of insulin for reaching target of blood glucose were significantly shorter /less than those in control group （ P〈0.001） .There was no statistically significant difference in the level of FBG , 2 h PG, HbA1c, Fins, HOMA-βor HOMA-IR between the two groups

关 键 词：甘精胰岛素 赖脯胰岛素 门冬胰岛素 2型糖尿病 血糖波动 

分 类 号：R587.1[医药卫生—内分泌]