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目的分析不同胰岛素强化治疗方案对初诊2型糖尿病患者血糖控制及血管内皮功能的影响。方法采用随机数字表法将123例初诊2型糖尿病患者均分为普通胰岛素组、胰岛素类似物组和预混胰岛素组,动态观察血糖达标后毛细血管全血血糖水平;血糖达标时间,胰岛素总用量、血糖波动系数、平均血糖波动幅度、血管内皮功能和低血糖发生率。结果 3组均可有效控制血糖水平,在7:00比较,胰岛素类似物组明显优于普通胰岛素组和预混胰岛素组,差异有统计学意义(P<0.05);在血糖达标时间,胰岛素用量、血糖波动系数、平均血糖波动幅度、改善血管内皮功能和低血糖发生率无明显差异,差异有统计学意义(P>0.05)。结论三餐前门冬胰岛素配合晚上10:00给予甘精胰岛素治疗初诊2型糖尿病患者疗效确切,血糖控制显著,安全可靠,值得临床继续研究和探讨。
Objective To analyze the effects of different intensive insulin therapy on glycemic control and endothelial function in newly diagnosed type 2 diabetic patients. Methods 123 patients with newly diagnosed type 2 diabetes mellitus were randomly divided into normal insulin group, insulin analog group and premixed insulin group by random number table. The blood glucose level of blood capillary was measured dynamically after reaching the blood glucose level. The time of reaching blood glucose level, total insulin dosage , Blood glucose fluctuation coefficient, average blood glucose fluctuation, endothelial function and incidence of hypoglycemia. Results All the three groups were able to effectively control the blood glucose level. Compared with normal insulin group and premixed insulin group, the insulin analogue group was significantly better at 7:00 (P <0.05) , Blood glucose fluctuation coefficient, mean blood glucose fluctuation range, improvement of vascular endothelial function and incidence of hypoglycemia were not significantly different, the difference was statistically significant (P> 0.05). Conclusions Three meals of insulin aspart before treatment with insulin glargine at night for newly diagnosed type 2 diabetic patients have definite curative effect, significant control of blood glucose, safety and reliability, which deserves further research and discussion in clinic.