胰岛素联合阿卡波糖治疗改善血糖波动

Combination therapy of insulin and acarbose reduces glucose excursion in diabetic patients

目的观察胰岛素治疗联合阿卡波糖对血糖波动的影响。方法采用动态血糖监测系统（CGMS）对104例胰岛素治疗的糖尿病患者联合阿卡波糖治疗2周前后进行连续72h的血糖监测，比较治疗前后血糖波动变化。结果（1）加用阿卡波糖后明显减少血糖波动，空腹血糖变异系数（CV—FPG）、日间血糖平均绝对差（MODD）、日内平均血糖波动幅度（MAGE）、M值、日内血糖极差、高血糖时间（％）、高血糖曲线下面积（AUC）、餐后血糖尖峰值、餐后血糖达峰时间、餐后血糖波动幅度、餐后血糖波动总时间等波动指标均下降（均P〈0．05）；（2）阿卡波糖治疗明显减少低血糖（尤其是夜间低血糖）的次数、幅度、持续时间（均P〈0．05）；（3）治疗后胰岛素用量显著下降（均P〈0．05）。结论阿卡波糖治疗可以明显改善糖尿病患者的血糖波动，同时有效避免夜间低血糖；联合使用阿卡波糖，可减少胰岛素用量，并减少胰岛素引起的不良反应等。

Objective To investigate the effect of combination therapy of insulin and acarbose on glucose excursion in diabetic patients. Method With combination of acarbose to insulin treatment,blood glucose of 104 diabetic patients was determined by continuous blood glucose monitoring for 72 hours. Parameters for blood glucose excursion were analysed and compared before and after the 2-weeks＇ treatment. Results Acarbose significantly reduced parameters for measuring blood glucose excursion, including mean daily deviations in glucose, postprandial glucose excursions and hyperglycaemia. Acarbose also significantly reduced the incidence,amplitude and duration of hypoglycaemia（ especially nocturnal） ,as well as the insulin dose required （P〈0.05）. Conclusions Acarbose seems to ameliorate blood glucose excursions, to avoid nocturnal hypoglycemia and to reduce the insulin requirement,which may reduce the side effect of insulin.