地特胰岛素对2型糖尿病患者空腹血糖变异的影响

Effect of insulin detemir on coefficient of variation of fasting blood glucose in patients with type 2 diabetes

目的观察地特胰岛素(Det)对血糖控制不佳的2型糖尿病患者空腹血糖(FBG)变异的影响。方法 60例血糖控制不佳的2型糖尿病患者随机分为两组,每组30例。在原有治疗方案的基础上,Det组和精蛋白生物合成入胰岛素(NPH)组分别睡前加用Det或NPH,皮下注射,每日一次,疗程均为12周。检测治疗前后FBG、糖化血红蛋白(HbA_(1c))、空腹血糖变异系数(CV-FBG)等指标,并观察低血糖事件。结果治疗12周后,两组FBG及HbA_(1c)均较治疗前明显降低(P<0.05),组间无显著差异(P>0.05)。Det组CV-FBG为12.49±2.47,明显低于NPH组(14.95±3.31,P<0.05)。Det组患者体重增加(1.25±0.75)kg,体重增加幅度低于NPH组[(1.98±0.84)kg,P<0.05]。Det组低血糖发生率低于NPH组(7%vs.17%,P<0.05)。两组均未出现严重不良反应。结论 Det在控制血糖方面疗效与NPH相当,且能减少FBG变异,降低低血糖风险并减少体重增加。

AIM To investigate effect of insulin detemir （Det） on coefficient of fasting blood glucose （FBG） in patients with type 2 diabetes. METHODS A total of 60 variation （CV） of ptients with type 2 diabetes inadequately controlled were randomized into once- daily Det （n = 30） versus isophane protamine biosynthetic human insulin （NPH, n = 30） for 12 weeks. Outcome measures included FBG, glycosylated hemoglobin A/Ic （HbA/Ic）, CV-FBG, body weight and events of the hypoglycemia. RESULTS After 12 weeks of the treatment, FBG and HbA/Ic,, decreased significantly in both groups （P 〈 0.05）. There was no statistical significance in FBG and HbAlc between the two groups （P 〉 0.05）. The CV-FBG was lower in the Det group than that in the NPH group （12.49 ±2.47 vs. 14.95 ± 3.31, P 〈 0.05）. The mean weight gain and events of hypoglycemia were significantly lower in the Det group than those in the NPH group （（ 1.25 ± 0.75） kg vs.（ 1.98 ± 0.84） kg, 7% vs. 17%, P 〈 0.05）. No CONCLUSION Insulin detemir is as effective as NPH hypoglycaemia and weight gain. severe adverse reaction occurred in the two groups in glycemic control, and with reduction in CV- FBG,