初发2型糖尿病应用3种胰岛素强化治疗方案临床研究

Clinical Research of Three Kinds of Intensive Insulin Treatment in Primary Type 2 Diabetes

目的比较3餐前注射诺和锐30特充(A组),诺和灵R加睡前甘精胰岛素(B组)以及诺和灵R加睡前诺和灵N(C组)治疗初发2型糖尿病患者的短期疗效和安全性。方法住院的2型糖尿病患者随机采用3种胰岛素强化治疗方案,据血糖水平调节胰岛素剂量直至达标,比较整体血糖控制水平、达标时间和胰岛素使用量,以及低血糖发生率等。结果①3组经治疗后血糖均可达标,3组间血糖测定结果比较差异无统计学意义(P>0.05);②3组间比较血糖达标时间及胰岛素平均每日总用量比较差异无统计学意义(P>0.05);③低血糖发生率,当末梢血糖≤3.9 mmol/L,定义为低血糖。A组发生2例,发生率为6.7%;B组发生2例,发生率为6.7%;C组发生3例,发生率为10%。低血糖多出现在凌晨0:00～4:00。3组中无1例发生低血糖昏迷,3组低血糖发生率比较差异没有统计学意义(P>0.05)。结论 3种胰岛素强化治疗方案控制血糖的短期临床疗效和安全性没有明显差别,但需要更加关注监测夜间血糖。

Objective To study the short-term efficacy and safety of three insulin treatment,such as Insulin Aspart 30 Injection（A group）,Novolin R plus insulin glargine at bed time（B group） and Novolin R plus Novolin N at bedtime（C group）,in the treatment primary type 2 diabetic patients.Methods hospitalized patients with type 2 diabetes were randomized to 3 kinds of intensive insulin therapy.To adjust the insulin doses according to blood glucose levels.To compare the overall level of blood glucose control,compliance time,and insulin doses,and the incidence of low blood sugar,et al.Results ①The blood glucose level can be achieved up to the standard in allgroups after treatment and the results were not significant difference among three groups（P0.05）;②blood glucose standard time and the average total daily insulin dosage were no difference among three groups（P0.05）;③ In the aspect of incidence of hypoglycemia.It is defined as low blood sugar when the peripheral blood glucose ≤3.9 mmol/L.A group occurred in 2 cases,the rate was 6.7%;B group had 2 cases,the rate was 6.7%;C group 3 cases,the rate was 10%.Low blood glucose often seen in the early morning 0：00 to 4：00.There was no hypoglycemia coma occurred.the incidence of hypoglycemia in 3 groups was not statistically difference（P0.05）.Conclusion The short-term effect and safety of Three intensive insulin treatment in blood glucose control had no significant difference.But we need to pay more attention to night blood glucose monitoring.