地特胰岛素联合不同口服药物对2型糖尿病血糖波动和低血糖发生的影响

Blood glucose fluctuation and hypoglycemic incidence in type 2 diabetes mellitus cured with insulin detemir and different oral antidiabetic drug

目的评价地特胰岛素分别联合阿卡波糖和瑞格列奈治疗2型糖尿病(T2DM)时血糖波动幅度(MAGE)和低血糖发生率的差异。方法采用病例对照研究,将72例2型糖尿病患者随机分为两组,阿卡波糖组使用每日1次地特胰岛素联合口服阿卡波糖,瑞格列奈组使用每日1次地特胰岛素联合口服瑞格列奈,采用动态血糖监测的方法,评价2种治疗方案下患者血糖波动情况和低血糖发生率的差异。结果阿卡波糖组平均血糖波动幅度及低血糖事件发生率低于瑞格列奈组,差异均有统计学意义(P<0.05);阿卡波糖组三餐后平均血糖及全天血糖最低值高于瑞格列奈组,但差异无统计学意义(P>0.05);两组空腹血糖和糖化血红蛋白无明显差异(P>0.05)。结论地特胰岛素分别联合阿卡波糖和瑞格列奈治疗2型糖尿病患者均能有效控制血糖,但前者血糖波动幅度较小,低血糖事件较少,具有一定优势。

Objective To compare the differences of blood glucose fluctuation and hypoglycemic incidence by dynamic glucose monitoring in type 2 diabetes mellitus （T2DM） cured with insulin detemir and acarbose or repaglinide. Methods Case-control study was used in our study. Seventy patients with type 2 diabetes were randomly divided into two groups. Acarbose group were treated with insulin detemir and acarbose, repaglinide group were treated with insulin detemir and repaglinide. Analyzed the differences of blood glu- cose fluctuation and hypoglycemic incidence by dynamic. Results Acarbose group＇s mean amplitude of g d ycemic excursion and hypoglycemic incidence were lower than repaglinide group, there was significant fference （P d0.05）. The average blood glucose after meal and minimum value of all-day blood glucose were higher than repaglinide group, but the difference was not statistically significant （P 〉0.05） ; There was no significant difference in fasting plasma glucose and glycosylated hemoglobin between two groups （P〉0.05）. Conclusion The curative effect is similar between insulin detemir with acarbose and insulin det emir with repaglinide. But insulin detemir with acarbose has more superiority than insulin detemir with repaglinide.