口服降糖药血糖控制不佳的2型糖尿病患者加用地特胰岛素或中效胰岛素治疗的疗效比较

Efficacy and safety comparison of once-daily insulin detemir versus NPH insulin treatment as add-on therapy to previous oral antidiabetic drugs in poorly controlled type 2 diabetes

目的评估口服降糖药血糖控制不佳的T2DM患者联合地特胰岛素(Det)或中效胰岛素(NPH)治疗的有效性和安全性。方法 80例血糖控制不佳的T2DM患者随机分为Det组和NPH组。在16周治疗期调整胰岛素剂量至FPG≤6.0 mmol/L。记录治疗前后FPG、HbA_1 c、低血糖事件及体重。结果治疗16周,两组FPG及HbA_1c均较基线下降,差异无统计学意义。Det组的体重增加明显低于NPH组,且低血糖风险减少42%。结论相比NPH,Det在有效控制血糖的同时,能降低低血糖发生风险及减少体重增加。

Objective To assess efficacy and safety of insulin detemir versus NPH insulin treatment as add-on therapy to previous oral antidiabetic therapy for type 2 diabetes. Methods 80 Patients with type 2 diabetes inadequately controlled were randomized to addition of once-daily insulin detemir versus NPH insulin for 16 weeks. Insulin doses were titrated toward prebreakfast glucose targets ≤6.0mmol/L. Outcome measures included fasting blood glucose （FBG）, HbAlc, events of hypoglycemia, and body weight. Result After 16 weeks of treatment, FPG decreased from 9.90 to 6.89 mmol/L in insulin detemir and 10. 01 to 6.78 mmol/L in insulin NPH,respectively （P〉0. 05）. HbAl c decreased by 1. 60% and 1.57% for detemir and NPH （P〉0. 05）, respectively. Compared with NPH insulin, the events of all hypoglycemia in insulin detemir group was reduced by 42%. Mean weight gain was 2.59 kg in insulin detemir and 3.10 kg in NPH insulin （P〈0.05）. Conclusion Insulin detemir is as effective as NPH in glycemic control, but with reduced hypoglycemic events and less weight gain.