比较地特胰岛素和中性鱼精蛋白锌胰岛素对2型糖尿病血糖的影响

Effect of detemir and neutral protamine hagedorn on blood glucose level in type 2 diabetes patients: A comparative study

目的比较睡前注射地特胰岛素和中性鱼精蛋白锌胰岛素(Neutral Protamine Hagedorn,NPH)联合口服降糖药(OAD)对OAD控制不佳的2型糖尿病(Diabetes Mellitus,DM)患者血糖控制的影响。方法共入选36例2型DM患者,随机给予睡前注射地特胰岛素和NPH治疗。分别于治疗前后测定HbA1c、FBG及行动态血糖监测(Continuous Glucose Monitoring System,CGMS)。结果 20周时地特组和NPH组HbA1c分别由9.19%和8.72%降至7.81%和7.39%,FBG分别由11.7mmol/L和11.0mmol/L降至6.59mmol/L和6.29mmol/L(P<0.05),治疗前后两组间无统计学差异。地特组血糖变异系数较治疗前显著下降,并显著低于NPH组。治疗前后地特组和NPH组的体质量增加分别为(-1.22±1.84)kg和(2.19±2.81)kg(P<0.05)。地特素组低血糖事件发生率明显低于NPH组,且无夜间低血糖事件。结论地特胰岛素联合OAD治疗与NPH具有相似的血糖控制,但地特胰岛素治疗的患者血糖控制更加平稳。

Objective To compare the effects of detemir and neutral protamine hagedorn（NPH） injection in combination with oral anti-diabetes drugs（OAD） on blood glucose level in type 2 diabetes patients with a poor response to OAD.Methods Thirty-six type 2 diabetes patients were randomized into two groups,which were treated with detemir＋ OAD and NPH＋ OAD for 20 weeks,respectively.HbA1C,FBG and glucose levels were monitored with a continuous glucose monitoring system（CGMS） before and after treatment.Results At week 20,the HbA1c decreased from 9.19% to 8.72 % in detemir＋ OAD group and from 7.81% to 7.39% in NPH＋OAD group,respectively,while the FBG decreased from 11.7mmol/L to 6.59mmol/L in detemir ＋ OAD group and from 11.0mmol/L to 6.29mmol/L in NPH＋OAD group,respectively（P0.05）.No significant difference was found in HbA1c and FBG between the two groups before and after treatment.The coefficient of variation（CV） for blood glucose was significantly lower after treatment than before treatment in detemir＋ OAD and NPH＋ OAD groups.The average body weight gain in two groups was（-1.22±1.84）kg and（2.19±2.81）kg,respectively（P0.05）.The incidence rate of hypoglycemia was significantly lower in detemir＋ OAD group than in NPH＋OAD group and no hypoglycemia occurred in night.Conclusion The effect of detemir＋ OAD and NPH ＋ OAD on blood glucose in patients with type 2 diabetes is similar.However,detemir＋ OAD is advantageous over NPH ＋OAD in control of body weight gain.