两种胰岛素方案治疗2型糖尿病的疗效与安全性比较

Comparision of curative effect and safety in two insulin project for the treatment of type 2 diabetes

目的:比较赖脯胰岛素联合中效胰岛素(中性鱼精蛋白锌胰岛素,neutral protaminehagedorn,NPH)与常规猪胰岛素(regular insulin,RI)联合甘精胰岛素2种方案治疗2型糖尿病的疗效和低血糖发生情况。方法:将32例2型糖尿病患者设为A组,30例2型糖尿病患者设为B组。A组采用餐前皮下注射赖脯胰岛素加睡前皮下注射NPH治疗,B组采用餐前皮下注射RI加睡前皮下注射甘精胰岛素治疗,治疗12周后分析2种方案的胰岛素剂量、降低血糖效果以及低血糖发生率。结果:2种方案降低血糖的疗效相当。B组睡前用的甘精胰岛素剂量明显多于A组所用的NPH剂量,B组餐前所用RI剂量明显少于A组赖脯胰岛素剂量,同时B组的低血糖发生率明显低于A组。结论:2种治疗方案均能够有效控制血糖,与餐前皮下注射赖脯胰岛素加睡前皮下注射NPH方案相比,餐前皮下注射RI加睡前皮下注射甘精胰岛素方案不易发生低血糖。

Objective： To compare the efficacy in controlling blood glucose and the incidence of hypoglycaemia of two insulin regimes insulin lispro/neutral protamine hagedorn （NPH） and regular insulin （RI） / insulin glargine for the treatment of type 2 diabetes. Methods： Thirty-two type 2 diabetes patients were assigned to group A and 30 were assigned to group B. Group A was treated with insulin lispro （subcutaneous injection before meals） and NPH （subcutaneous injection at bedtime）, while group B was treated with RI （subcutaneous injection before meals） and insulin glargine （subcutaneous injection at bedtime）. The dosage of insulin, the effect of depressing blood glucose and incidence of hypoglyeaemia were compared between the two groups. Results： There was no statistical difference about the blood glucose controls after the 12 weeks of treatments between group A and group B. The dosage of Glargine in group B was significantly higher than that of NPH in group A. The dosage of RI in group B was significantly less than that of Lispro in group A. The incidence of hypoglycaemia in group B was significantly lower than that of group A. Conclusion ： Both therapeutic regimen were good in controlling blood glucose. Compared with the plan of insulin lispro and NPH, the incidence of hypoglycaemia was lower in plan of RI and insulin glargine.