地特胰岛素联合阿卡波糖治疗口服降糖药失效的老年2型糖尿病的有效性和安全性观察

Efficacy and safety of detemir plus acarbose in elderly T2DM patients with failure of glucose control by oral anti-diabetic drugs

目的评价地特胰岛素联合阿卡波糖治疗口服降糖药失效的老年T2DM的有效性和安全性。方法将60例口服降糖药失效的老年T2DM患者,随机分为地特胰岛素联合阿卡波糖组和预混人胰岛素(诺和灵30R)组进行治疗,观察治疗前后的FBG、2hBG、HbA1c、C-P、BMI、低血糖发生率、胰岛素用量。结果治疗后,两组患者的FBG、2hBG、HbA1c均较基线显著降低(P<0.05),两组间差异无统计学意义(P>0.05);但地特胰岛素组在胰岛素用量、低血糖发生率、体重增加方面均低于诺和灵30R组(P<0.05),C-P水平明显升高(P<0.05)。结论地特胰岛素与阿卡波糖联合治疗方案对于老年T2DM患者安全、有效、方便,低血糖发生率小,地特胰岛素可改善胰岛功能。

Objective To evaluate the efficacy and safety of insulin detemir combined with acarbose in treating elderly T2DM patients with failure of glucose control by oral anti-diabetic drugs.Methods Sixty cases of elderly T2DM patients with failure of glucose control by oral anti-diabetic drugs were randomized into two groups,one was treated by insulin detemir combined with acarbose,and the other by premixed human insulin 30R.Before and after treatment,the FBG,2 hBG,HbA1c,C-P,BMI,incidence of hypoglycemia,and insulin dose were observed for comparison.Results After treatment,the levels of FBG,2 hBG,and HbA1c decreased significantly from baseline in both groups(P<0.05),the difference between the 2 groups was not significant in statistics(P>0.05);however,the insulin dose,the incidence of hypoglycemia,and weight increase were all less in the detemir group than in the insulin 30R group(P<0.05).The serum C-peptide level increased significantly in the detemir group(P<0.05).Conclusion The treatment with insulin detemir combined with acarbose is effective,safe,and convenient for elderly T2DM patients.It is superior in low incidence of hypoglycemia and being able to improve islet function.