阻塞性睡眠呼吸暂停综合征合并2型糖尿病血糖管理

Glucose management in type 2 diabetes combined with Obstructive Sleep Apnea Syndrome

目的探讨阻塞性睡眠呼吸暂停综合征合并2型糖尿病患者的降糖方案。方法 51例阻塞性睡眠呼吸暂停综合征合并2型糖尿病患者随机分为A组和B组。A组使用预混胰岛素治疗,B组在A组方案基础上加用艾塞那肽治疗,随访4个月,比较两组患者血糖控制、胰岛素抵抗指数、胰岛β细胞功能以及血脂、呼吸功能等变化情况。结果两组患者血糖均得到良好控制,B组患者BMI、TG、HOMA-IR较A组低;HOMA-β、FC-P较A组高。另外,两组呼吸功能均有改善,B组AHI、ESS评分低于A组;SPO2、最低SPO2较A组高。结论 OSAS合并2型糖尿病患者采用艾塞那肽联合胰岛素治疗可以安全有效控制血糖,调节血脂,改善胰岛素抵抗,进而改善低氧血症。

Objective To observe the glucose management in type 2 diabetes combined with Obstructive Sleep Apnea Syndrome. Methods Fifty- one patients with T2DM with OSAS were divided into two groups： Premixed insulin injection group （ group A ） and premixed insulin plus exenatide injection group（ group B）. The glucose level, βcell function, blood fat and BMI were measured at base- line and 4 months after treatment to analyze the changes of various parameters of respiratory disturbance. Results Excellent control of blood glucose was achieved in both groups. BMI, TG, HOMA-IR, AHI and ESS were lower in group B than those in group A; FC-P, HOMA-β and SPO2 were higher in group B than those in group A. Concultion The application of excnatidc combined with insulin thera- py in type 2 diabetic patients with OSAS can not only quickly, effectively and safely control glucose, but also improve the postoperative in- sulin resistance and hypoxemia.