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目的:观察甘精胰岛素注射联合口服降糖药阿卡波糖对老年2型糖尿病患者的血糖控制情况和低血糖的风险。方法:选择口服降糖药物控制不良的老年2型糖尿病患者84例,随机分为甘精胰岛素组(简称甘精组)和强化胰岛素组(简称强化组),每组各42例,甘精组在每天三餐时口服阿卡波糖的基础上,每晚10:00注射甘精胰岛素1次,强化组分别于三餐前30min注射诺和灵R,每晚10:00注射诺和灵N,根据餐前血糖及餐后血糖水平,以餐前血糖<8mmol.L-1,餐后2h<10mmol.L-1为治疗目标,观察血糖控制和低血糖发生情况。结果:治疗18周后,两组的全天血糖谱和糖化血红蛋白(HbAlc)明显下降(P<0.05)。甘精组BMI无显著变化,强化组则升高明显。低血糖发生率甘精组2例,强化组31例(P<0.05)。结论:两组均控制血糖明显,但低血糖发生及体重增加情况甘精组明显低于强化组。
Objective: To observe the glycemic control and the risk of hypoglycemia in elderly patients with type 2 diabetes mellitus with insulin glargine combined with oral hypoglycemic acarbose. Methods: Eighty-four elderly patients with type 2 diabetes who were poorly controlled by oral hypoglycemic drugs were randomly divided into insulin glargine group and intensive insulin group, 42 cases in each group, On the basis of orally taking acarbose at three meals per day, insulin glargine was injected once a day at 10:00 and in the fortified group, norepinephazole was injected at 30 minutes before the three meals. , According to the pre-dinner blood glucose and postprandial blood glucose levels, the pre-prandial blood glucose <8mmol.L-1, postprandial 2h <10mmol.L-1 as the treatment goal, observe the blood sugar control and hypoglycemia. Results: After 18 weeks of treatment, the blood glucose and hemoglobin A1c (HbA1c) decreased significantly in both groups (P <0.05). There was no significant change in BMI in Ganzhi group, and obvious increase in Fortified group. Hypoglycemia occurred in 2 cases in Gan Gan group and in 31 cases in Fortified group (P <0.05). Conclusion: Both groups control blood glucose significantly, but the incidence of hypoglycemia and weight gain in Gan Gan group was significantly lower than that in intensive group.