论文部分内容阅读
目的研究门冬胰岛素50对2型糖尿病患者餐后血糖、血脂、胰岛细胞功能的影响,并进行安全性评价。方法 2016年1月至2016年7月收治的82例2型糖尿病患者,根据随机数字表分为常规治疗组和门冬胰岛素50组,每组41例。常规治疗组采用精蛋白生物合成人胰岛素注射液(预混50R)进行治疗,门冬胰岛素50组采用门冬胰岛素50进行治疗。观察2组血糖(治疗前和治疗8周时的空腹血糖、早餐后2h血糖、中餐后2h血糖、晚餐后2h血糖及糖化血红蛋白水平)、血脂(治疗前和治疗8周时的总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇水平)、胰岛细胞功能变化[C肽(空腹、餐后2h)水平、胰岛素(空腹、餐后2h)水平,采用稳态模型计算胰岛素敏感指数和胰岛β细胞功能指数]、临床治疗效果(血糖达标时间、日胰岛素用量、血糖波动次数和平均血糖波动幅度),并对治疗期间不良反应进行分析。结果 2组治疗后空腹、早餐后2h、中餐后2h、晚餐后2h血糖以及糖化血红蛋白水平均显著低于治疗前,差异有统计学意义(P<0.05),门冬胰岛素50组治疗后血糖和糖化血红蛋白水平低于常规治疗组,差异有统计学意义(P<0.05)。2组治疗后总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇水平均低于治疗前,差异有统计学意义(P<0.05)。2组治疗后血脂水平比较,差异无统计学意义(P>0.05)。2组治疗后空腹、餐后2h C肽、胰岛素水平,胰岛素敏感指数,胰岛β细胞功能指数均显著高于治疗前,差异有统计学意义(P<0.05),门冬胰岛素50组空腹、餐后2h C肽水平,餐后2h胰岛素水平,胰岛素敏感指数和胰岛β细胞功能指数均显著高于常规治疗组,差异有统计学意义(P<0.05)。门冬胰岛素50组治疗后血糖达标时间、血糖波动次数和平均血糖波动幅度均少于常规治疗组,差异有统计学意义(P<0.05)。门冬胰岛素50组轻微低血糖发生率低于常规治疗组,差异有统计学意义(P<0.05)。结论门冬胰岛素50治疗2型糖尿病可以显著降低患者的餐后2h血糖和糖化血红蛋白水平,调节脂质代谢,改善胰岛细胞的分泌能力,降低血糖达标时间、血糖波动次数和幅度,减少低血糖发生率。
Objective To study the effects of insulin aspart 50 on postprandial blood glucose, blood lipid and islet cell function in patients with type 2 diabetes mellitus (T2DM) and to evaluate the safety. Methods From January 2016 to July 2016, 82 patients with type 2 diabetes mellitus were divided into two groups according to a random number table: conventional treatment group and insulin aspart 50 group, 41 cases in each group. The conventional treatment group was treated with protamine biosynthesis human insulin injection (premixed 50R), and aspart insulin 50 was treated with insulin aspart 50. Blood glucose (fasting blood glucose before and 8 weeks after treatment, blood sugar at 2h after breakfast, blood sugar at 2h after meal, blood sugar at 2h after dinner and level of glycosylated hemoglobin), blood lipids (total cholesterol before treatment and 8 weeks of treatment, Acylglycerol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, islet cell function changes [C peptide (fasting, postprandial 2h), insulin (fasting, postprandial 2h) levels, using a steady-state model to calculate insulin sensitivity Index and pancreatic β-cell function index], clinical treatment effect (blood glucose compliance time, daily insulin dosage, blood glucose fluctuation and average blood glucose fluctuation range), and analysis of adverse reactions during treatment. Results After treatment, fasting, 2h after breakfast, 2h after meal, 2h after meal, and HbA1c were significantly lower than those before treatment (P <0.05) HbA1c levels were lower than those in the conventional treatment group (P <0.05). The levels of total cholesterol, triglyceride, high density lipoprotein cholesterol and low density lipoprotein cholesterol in the two groups after treatment were all lower than those before treatment (P <0.05). There was no significant difference in blood lipid levels between the two groups after treatment (P> 0.05). The fasting, postprandial C peptide, insulin level, insulin sensitivity index and beta cell function index of 2 groups after treatment were significantly higher than those before treatment (P <0.05), fasting insulin aspart 50 The levels of C peptide, 2h postprandial insulin, insulin sensitivity index and islet β cell function index were significantly higher than those in the conventional treatment group at 2h after operation (P <0.05). Aspart insulin 50 groups after treatment, blood glucose compliance time, blood glucose fluctuations and average blood glucose fluctuations were less than the conventional treatment group, the difference was statistically significant (P <0.05). The incidence of mild hypoglycemia in insulin aspart 50 group was lower than that in routine treatment group (P <0.05). Conclusions Aspart 50 in treatment of type 2 diabetes mellitus can significantly reduce 2h postprandial blood glucose and glycosylated hemoglobin level, regulate lipid metabolism, improve pancreatic islet cell secretory capacity, reduce blood glucose compliance time, frequency and amplitude of blood glucose fluctuation and reduce hypoglycemia rate.