论文部分内容阅读
目的比较口服药控制不佳的2型糖尿病患者加用1次/d地特胰岛素(诺和平)或诺和灵N(NPH)治疗的有效性、安全性及体质量的变化。方法选取我院2009年11月至2010年1月就诊的60例口服药控制不佳的2型糖尿病患者,保持原有口服药方案不变,分为2组,每组30例,治疗组加用1次/d睡前地特胰岛素注射,对照组加用NPH,起始剂量均为0.2U/(kg.d),然后根据2～3次平均空腹血糖每周调整1次胰岛素剂量,直至空腹血糖达到4.4～6.1mmol/L。治疗期为12周,比较2组治疗前后FPG、HbA1c、体质量的变化及低血糖事件的发生。结果两组治疗后的HbA1c和FPG同治疗前相比均有明显下降(P<0.01),但组间比较无统计学差异(P>0.05);与对照组相比,治疗组体质量增加少[分别为(1.6±0.3)kg和(0.6±0.1)kg,P<0.01]。治疗组发生1例轻度低血糖(3.3%),对照组发生5例轻度低血糖(16.5%),治疗组低血糖发生率低(P<0.01)。2组均无严重低血糖及其他严重不良反应发生。结论口服药治疗不佳的2型糖尿病患者,加用1次/d睡前地特胰岛素治疗同NPH相比,有效性相似,但低血糖发生风险小、体质量增加少。
Objective To compare the efficacy, safety and body weight of patients with poorly controlled oral administration of type 2 diabetes with insulin or norepinephrine once per day. Methods Sixty patients with poorly controlled type 2 diabetes mellitus were selected from November 2009 to January 2010 in our hospital. The original oral drug regimen remained unchanged. The patients were divided into two groups (n = 30 in each group) With 1 / d before bed insulin injection, the control group with NPH, the initial dose of 0.2U / (kg.d), and then according to 2 to 3 times the average fasting blood glucose adjusted weekly insulin dose, until Fasting blood glucose reached 4.4 ~ 6.1mmol / L. The treatment period was 12 weeks. The changes of FPG and HbA1c before and after treatment were compared between the two groups, and the incidence of hypoglycaemia was also observed. Results The HbA1c and FPG after treatment in both groups were significantly lower than those before treatment (P <0.01), but there was no significant difference between the two groups (P> 0.05). Compared with the control group, the body weight of the treatment group increased less [(1.6 ± 0.3) kg and (0.6 ± 0.1) kg, respectively, P <0.01]. One mild hypoglycemia (3.3%) occurred in the treatment group, five mild hypoglycemia (16.5%) in the control group, and a low incidence of hypoglycemia in the treatment group (P <0.01). No severe hypoglycemia and other serious adverse reactions occurred in both groups. Conclusion The oral administration of type 2 diabetes patients with poor treatment, plus 1 / d before bed insulin treatment compared with NPH, the effectiveness of similar, but the risk of hypoglycemia, increased body weight less.