口服降糖药联合地特胰岛素治疗2型糖尿病的临床疗效

Therapeutic effects of insulin detemir combined with oral hypoglycemic agents on type 2 diabetic patients

目的探讨在服用降糖药治疗的T2DM患者中,每天加用一次地特胰岛素治疗的临床疗效及安全性。方法单纯口服降糖药治疗、血糖控制不佳的T2DM患者36例,对照组在口服药基础上加用中效胰岛素,治疗组在其口服药基础上加用每日一次地特胰岛素,就寝前注射,比较治疗前、治疗后12周、24周空腹血糖、HbA_1 c、血脂、血压、BMI变化,记录低血糖发生率。结果两组治疗后12、24周患者空腹血糖、HbA_1c较治疗前均明显降低(P<0.05);治疗后12、24周两组间空腹血糖、HbA_1c差异无统计学意义;地特胰岛素组低血糖发生率明显低于对照组(P<0.01);地特胰岛素组治疗24周后体重增加0.39kg,中效胰岛素组增加0.88kg,两组间差异无统计学意义。结论口服药物联合地特胰岛素能更有效控制血糖,低血糖发生率少,体重增加不明显。

Objective To investigate the clinical efficacy and safety of insulin detemir combined with oral hypoglycemic agents in treatment of type 2 diabetic patients. Methods 36 cases of type 2 diabetic patients treated with oral hypoglycemic agents were divided into NPH group（n= 20） and insulin detemir group（n= 16）. The fasting blood glucose, glycated hemoglobin, lipids, blood pressure, body mass index were compared between pretreatment and posttreatment for 12 and 24 weeks. Hypoglycemia events were recorded. Results Fasting blood glucose and glycated hemoglobin were significantly decreased after treatment for 12, 24 weeks in both groups （p〈0.05）. There were no significant differences in fasting blood glucose and glycated hemoglobin between the two groups after 12, 24 weeks of treatment. Hypoglycemic events were significanyly lower in insulin detemir group than in NPH group （p〈0. 01 ）. Weight gain was 0.39kg in insulin detemir group and 0.88kg in NPH group, there was no significant difference between two groups. Conclusion Insulin determir combined with oral hypoglycemic agents can effectively decrease blood glucose, with less incidence of hypoglycemia and less weight gain.