来得时联合普通胰岛素强化治疗初发2型糖尿病疗效观察

Effect of Intensive Insulin Treatment with Insulin and Garline on Newly Diagnosed Type 2 Diabetic Mellitus

目的:探讨早期胰岛素强化治疗初发2型糖尿病方案的优劣。方法:对2006年1月～2009年6月住院初发2型糖尿病患者90例进行回顾分析。空腹血糖(FBG)≥11.1mmol/L,HBA1C≥9.0%。根据当时采用的不同的胰岛素治疗方案,分成A、B、C三组。A组采用来得时联合普通胰岛素治疗,B组采用诺和灵N联合普通胰岛素治疗,C组采用预混胰岛素(诺和灵50R或30R)治疗。三组均在胰岛素治疗基础上,同时应用阿卡波糖、二甲双胍,不用促胰岛素分泌剂。比较三组降糖效果、血糖控制时间、胰岛素总量及低血糖发生率。结果:三组均显示明显的降糖效果,其中以A组来得时联合普通胰岛素治疗方案最优,血糖达标时间最短,胰岛素用量最少,低血糖发生率最低。结论:初发2型糖尿病患者早期胰岛素强化治疗中,来得时联合普通胰岛素能更有效地控制血糖水平,降低高糖毒性,减少胰岛素抵抗,促使胰岛β细胞功能恢复。

Objective：To investigate the effect of early intensive insuline treatment on newly diagnosed type 2 diabetic mellitus. Methods： A total of 90 patients with newly diagnosed type 2 diabetic mellitus in the hospital from January 2006 to June 2009 were retrospectively analyzed. The diagnosis was made with fasting blood glucose ≥ 11.1 mmol/L and HBA1C ≥ 9.0%. The patients were divided into 3 groups according to different drugs added to insulin： insulin garline injection（ Group A） ,Novolin（ Group B） ,and Novolin 50R or 30R（ Group C）. All groups were coadministered with acarbose and mefformin and no drug was used to promote insulin secretion. Blood glucose, time to glucose baseline, total dosage of insulin, and hypoglycemia were compared between the 3 groups. Results： The level of blood glucose was markedly reduced in all groups. Group A achieved the least time to reach normal blood glucose, the least dosage of insulin, and the lowest incidence of hypoglycemia. Conclusion： Intensive protocol with insulin and insulin garline injection has better effects on managing blood glucose, reducing insulin resistance, and promoting islet 13 cell function.