地特胰岛素对2型糖尿病肥胖及非肥胖患者血糖及体重的影响

The effects of insulin detemir on blood glucose and body weight in obese and non-obese type 2 diabetic patients

目的观察地特胰岛素治疗24周对2型糖尿病(T2DM)肥胖及非肥胖患者血糖及体重的影响。方法选取既往未接受过胰岛素治疗的T2DM患者54例,根据BMI分为肥胖(Ob)组24例和非肥胖(NOb)组30例,检测治疗前后体重、FBG、HbA_1c,计算BMI、胰岛素用量等。结果地特胰岛素治疗24周后,Ob组和NOb组FBG[(7.3±1.2)mmol/L、(6.7±1.5)mmol/L]、HbA_1c[(7.3±0.9)%、(6.5±0.8)%]均较基线值{FBG[(9.4±2.5)mmol/L、(8.1±1.7)mmol/L]、HbA_1c[(8.2±1.1)%、(7.6±1.9)%]}明显下降(P<0.05);Ob组治疗前后BMI变化[(-1.51±1.10)kg/m^2]与NOb组[(0.15±1.00)kg/m^2]比较,差异有统计学意义(P<0.05)。结论地特胰岛素治疗可有效降低肥胖和非肥胖T2DM患者血糖,且无明显体重增加效应。

Objective To observe the effects of insulin detemir on blood glucose and body weight in obese and non-obese type 2 diabetic patients. Methods 54 T2DM patients never receiving insulin treatment were divided into 2 groups： obesity（BMI≥24 kg/m2 ,n=24） and non-obesity（BMI〈24 kg/m2 , n=30）. The efficacy of insulin detemir treatment for 24 weeks was analyzed. Results FBG（mmol/L） was lower at 24-w of treatment in both Ob （7.3±1.2 vs 9.4±2.5） and NOb （6.7±1.5 vs 8.1±1.7） than at baseline （all P〈0.05）. There was no significant difference in FBO decrement between Ob and NOb groups. HbAlc （%） was lower at 24-w of treatment in both Ob （7.3±0. 9 vs 8.2±1.1） and NOb （6.5±0. 8 vs 7.6± 1.9） group than at baseline （all P〈0. 05）, but no significant difference in HbAlc decrement between Ob and NOb. BMI （kg/m2） showed no change （P〉0. 05） between baseline and 24-w of treatment group, but the BMI decrement was more in Ob than in NOb （1.51±1.10 vs 0. 15±1.00） （P〈0. 05）. Insulin dosage （U/kg） was more at 24-w of treatment in both Ob （0.23±0. 15 vs 0. 13± 0. 02） and NOb （0.19±0. 06 vs 0. 12＋0.03） than at baseline （all P〈0.05）. （P〈0. 05）. Conclusions Detemir can effectively control the glucose level in both obesity and non-obesity without weight gain.