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目的:评价门诊起始胰岛素疗法对老年2型糖尿病患者的临床疗效和安全性。方法:将口服降糖药血糖控制不理想的老年2型糖尿病患者将其分为观察组和对照组,对照组患者给予继续口服降糖药格列美脲片(亚莫利,Amaryl,以下简称AML)与阿卡波糖片(拜糖平,Acarbose,以下简称ACB),观察组患者给予每日晨起口服AML,每晚9点30分注射地特胰岛素(Insulin Detemir,以下简称IDT),治疗期间严密监测患者血糖控制情况,并予饮食指导、低血糖健康教育,鼓励患者积极运动,比较2组患者治疗前后空腹血糖(FBG)、餐后2 h血糖(2h PBG)及糖化血红蛋白(Hb A1c)的变化情况,观察其低血糖事件发生情况和治疗依从性。结果:2组患者治疗后的FBG、2h PBG和Hb A1c均较治疗前显著降低(P<0.05),治疗后观察组患者的FBG、2h PBG和Hb A1c显著低于对照组(P<0.05);观察组患者的低血糖事件发生率与治疗依从性均显著优于对照组(P<0.05)。结论:门诊起始胰岛素疗法可有效控制老年2型糖尿病患者的血糖水平,降低低血糖事件的发生率,提高了患者的治疗依从性。
Objective: To evaluate the clinical efficacy and safety of outpatient initial insulin therapy in elderly patients with type 2 diabetes mellitus. Methods: Patients with type 2 diabetes mellitus who were under-controlled by oral hypoglycemic agents were divided into observation group and control group. Patients in control group were given oral sustained-release glimepiride tablets (Yamouli, Amaryl, hereinafter referred to as (AML) and acarbose (Acarbose, hereinafter referred to as ACB). Patients in the observation group were given daily morning oral AML, Insulin Detemir (IDT) at 9:30 every night, During the treatment period, the patients’ blood glucose control was closely monitored. Dietary guidance and hypoglycemia health education were encouraged to encourage active exercise. The fasting blood glucose (FBG), postprandial 2h PBG and HbAb A1c) changes, observe the occurrence of hypoglycemic events and treatment compliance. Results: After treatment, FBG, 2h PBG and Hb A1c in both groups were significantly lower than those before treatment (P <0.05). FBG, 2h PBG and Hb A1c in the observation group were significantly lower than those in the control group after treatment (P <0.05) The incidence of hypoglycaemia and treatment compliance in the observation group were significantly better than those in the control group (P <0.05). Conclusion: Outpatient initial insulin therapy can effectively control the blood sugar level in elderly patients with type 2 diabetes mellitus, reduce the incidence of hypoglycemic events and improve the patient’s compliance with treatment.