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目的比较地特胰岛素与甘精胰岛素治疗初诊2型糖尿病的安全性与有效性。方法选取于大连大学附属中山医院就诊的初诊2型糖尿病患者90例,应用随机数表法分为地特胰岛素组与甘精胰岛素组各45例,分别给予地特胰岛素与甘精胰岛素皮下注射治疗,根据血糖情况每3~4d调整剂量。治疗前以及治疗12周后检测二组患者的空腹静脉血浆血糖(FBG)、餐后2h静脉血浆血糖(2hPBG)、糖化血红蛋白(HbAlc)和体重,并记录不良反应。结果地特胰岛素组患者治疗前后的FBG(9.60±1.05 vs 6.92±0.78)mmol/L、2hPBG(12.87±1.97 vs 9.70±0.95)mmol/L、HbA1c(8.32±0.76 vs 7.08±0.67)%比较,治疗后各项指标均低于治疗前,差异均有统计学意义(P<0.05);甘精胰岛素组患者治疗前后的FBG(9.76±1.14 vs 6.93±0.83)mmol/L、2hPBG(13.44±2.21 vs 9.86±1.09)mmol/L、HbA1c(8.25±0.73vs 6.97±0.61)%比较,治疗后各项指标均低于治疗前,差异均有统计学意义(P均<0.05),但二组患者治疗后的FBG(6.92±0.78 vs 6.93±0.83)mmol/L、2hPBG(9.70±0.95vs 9.86±1.09)mmol/L、HbA1c(7.08±0.67 vs 6.97±0.61)%比较差异均无统计学意义(P>0.05);地特胰岛素组患者的治疗达标率为80.00%,高于甘精胰岛素组的73.33%,但差异无统计学意义(P>0.05);治疗期间,地特胰岛素组患者的不良反应发生率为12.50%,低于甘精胰岛素组的13.33%,但差异无统计学意义(P>0.05);地特胰岛素组与甘精胰岛素组患者胰岛素用量分别为(14.82±2.80)U和(15.31±3.54)U,差异无统计学意义(P>0.05);与治疗前相比,地特胰岛素患者与甘精胰岛素组患者体重增加量分别为(1.17±0.99)kg和(1.90±1.07)kg,甘精胰岛素组患者体重增加多,且差异有统计学意义(P均<0.05)。结论地特胰岛素与甘精胰岛素治疗初诊2型糖尿病均有效,且安全性较好,相对于甘精胰岛素,地特胰岛素更具有体重优势。
Objective To compare the safety and efficacy of insulin detemir and insulin glargine in the treatment of newly diagnosed type 2 diabetes mellitus. Methods Ninety patients with newly diagnosed type 2 diabetes who were admitted to Zhongshan Hospital Affiliated to Dalian University were enrolled in this study. They were divided into insulin detemir group and insulin glargine group (n = 45) by random number table, and were given insulin detemir and insulin glargine subcutaneously , According to the blood glucose every 3 ~ 4d dose adjustment. Fasting venous plasma glucose (FBG), postprandial 2h venous plasma glucose (2hPBG), HbAlc and body weight were measured before treatment and after 12 weeks of treatment. Adverse reactions were recorded. Results Compared with the control group, FBG (9.60 ± 1.05 vs 6.92 ± 0.78) mmol / L, 2h PBG (12.87 ± 1.97 vs 9.70 ± 0.95) mmol / L and HbA1c (8.32 ± 0.76 vs 7.08 ± 0.67% The levels of FBG (9.76 ± 1.14 vs 6.93 ± 0.83) mmol / L, 2h PBG (13.44 ± 2.21) before and after treatment in insulin glargine group were significantly lower than those before treatment (9.86 ± 1.09) mmol / L and HbA1c (8.25 ± 0.73 vs 6.97 ± 0.61)%, respectively. All the indexes after treatment were lower than those before treatment (all P <0.05) After treatment, there were no significant differences in FBG (6.92 ± 0.78 vs 6.93 ± 0.83) mmol / L, 2h PBG (9.70 ± 0.95 vs 9.86 ± 1.09) mmol / L and HbA1c (7.08 ± 0.67 vs 6.97 ± 0.61)% P> 0.05). The treatment compliance rate in insulin detemir group was 80.00%, which was higher than 73.33% in insulin glargine group, but the difference was not statistically significant (P> 0.05). During the treatment, The response rate was 12.50%, which was lower than that of insulin glargine group (13.33%), but the difference was not statistically significant (P> 0.05). The insulin dosage of insulin detemir group and insulin glargine group were (14.82 ± 2.80) U (15.31 ± 3.54) U, the difference was not statistically significant (P> 0.05). Compared with before treatment, the body weight gain of insulin detemir and insulin glargine groups were (1.17 ± 0.99) kg and (1.90 ± 1.07 ) kg, glargine group patients with more weight gain, and the difference was statistically significant (P all <0.05). Conclusion Both insulin detemir and insulin glargine are effective in treating newly diagnosed type 2 diabetes mellitus, and their safety is better. Detemir insulin has more weight advantage than insulin glargine.