初诊2型糖尿病短期强化治疗后应用甘精胰岛素临床观察

Clinical observation of insulin glargine in treatment of newly diagnosed type 2 diabetes mellitus after short-term intensified treatment

目的观察甘精胰岛素在初诊2型糖尿病短期强化治疗后的临床应用。方法选择68例强化治疗后血糖控制不理想的新诊断2型糖尿病患者,将其随机分成两组,甘精胰岛素组(35例)每日1次皮下注射,预混胰岛素(诺和灵30R)组(33例)每日2次皮下注射。观察两组患者的血糖控制情况,12周后观察两组患者糖化血红蛋白及C肽水平变化。结果两组患者血糖均明显下降,甘精胰岛素组空腹血糖下降幅度明显大于预混组(P<0.05);两组的胰岛功能均得到明显恢复,但差异无统计学意义(P>0.05)。甘精胰岛素组低血糖发生率明显低于对照组(P<0.05),甘精胰岛素组的胰岛素用量及体质量增加值低于预混组(P<0.05)。结论对短期强化治疗后新诊断2型糖尿病血糖控制不理想患者,应用甘精胰岛素或预混胰岛素进行治疗,均能达到明显的降糖效果,使胰岛功能得到明显恢复。其中甘精胰岛素降低空腹血糖效果更好,胰岛素用量较少,夜间低血糖发生率低,应用方便、安全、有效,患者依从性好,是值得临床应用推广。

Objective To observe the clinical effect of insulin glargine in the treatment of newly diagnosed type 2 diabetes mellitus after short-term intensified treatment.Methods Sixty-eight newly diagnosed type 2 diabetes mellitus with unsuccessful blood glucose control through insulin intensified treatment were randomly divided into two groups： glargine group（n=35） and pre-mixed insulin group（n=33）.The blood glucose and C-peptide levels of the two group were observed.Results The fasting blood glucose of the two groups reduced obviously at the 2 and 12 weeks after the treatment,with much more decrease in glargine group than that in pre-mixed group（P0.05）.The incidence of hypoglycemia in glargine group was obviously lower than that in pre-mixed group（P〈0.05）.The doses of insulin used and the body weight increased in glargine group were lower than those in pre-mixed group significantly（P〈0.05）.Conclusion Under unsuccessful control of blood glucose with newly diagnosed type 2 diabetes mellitus,intensified treatment by insulin pump in short-term,both insulin glargine and the pre-mixed insulin possess obvious effects of controlling the FBG and HAb1c,but the former is superior in lowing the incidence of hypoglycemia at night,with smaller dose than the latter.The glargine is convenient,safe and effective.The patients with diabetes mellitus are easily acceptance.It is worth be spread in the clinical application.