甘精胰岛素治疗1型糖尿病16例临床体会

Glargine for treatment of type 1 diabetes

目的比较每日注射一次甘精胰岛素与中性低精蛋白锌人胰岛素（NPH）分别联合3餐前注射短效人胰岛素（Novolin R）治疗1型糖尿病的疗效。方法16例1型糖尿病患者（包括儿童1型糖尿病3例，成人迟发自身免疫糖尿病13例）根据用药情况分为2组，甘精胰岛素组10例，每日3餐前注射Novolin R，8例患者每天22：00注射甘精胰岛素，2例患者每天7：00注射甘精胰岛素；对照组6例每日3餐前注射Nov-olin R，22：00注射NPH。根据血糖水平调整胰岛素用量，观察血糖变化和低血糖发生的情况。结果2组患者治疗后血糖均较治疗前明显下降（P〈0．01），2组血糖控制达标所用时间差异有统计学意义（P〈0．05），甘精胰岛素组酮体消退时间短于对照组（P〈0．05），日用胰岛素剂量低于对照组（P〈0．05），血糖平稳下降，血糖波动小，低血糖发生率低于对照组（P〈0．05）。结论长效重组甘精胰岛素能模拟人体生理性基础胰岛素分泌，利于1型糖尿病患者的血糖控制，安全性较好。

Objective To observe the effect of glargine for treatment of type 1 diabetes. Methods Sixteen type 1 diabetes patients were randomized in two groups. In the Glargine group, 10 patients were. given injection Novolin R before every meal and injection Glargine at bedtime daily. Meanwhile 6 patients in the NPH group were given injection Novolin R before every meal and injection NPH at bedtime daily. The dosage of insulin was adjusted by blood glucose level, seeking a target of FBG ≤6.5 mmol/L and 2 h PBG≤10.0 mmol/L. The blood glucose level and incidence of hypoglycemia were observed. Results Mean blood glucose level was similiar in the 2 groups （ P 〉 0.10）, but the incidence of hypoglycemia in the Glargine group was significantly lower than that in the NPH group （ P 〈 0. 05 ）. Conclusion Glargine initiates the physiological secretion of insulin and controls the blood glucose level more effectively.