门诊起始胰岛素疗法对92例老年2型糖尿病患者临床疗效和安全性评价

Clinical Efficacy and Safety for Using Out-patients Initial Insulin Therapy in 92 Elderly Patients with Type 2 Diabetes

目的:评价门诊起始胰岛素疗法对老年2型糖尿病患者的临床疗效和安全性。方法:将口服降糖药血糖控制不理想的老年2型糖尿病患者将其分为观察组和对照组,对照组患者给予继续口服降糖药格列美脲片(亚莫利,Amaryl,以下简称AML)与阿卡波糖片(拜糖平,Acarbose,以下简称ACB),观察组患者给予每日晨起口服AML,每晚9点30分注射地特胰岛素(Insulin Detemir,以下简称IDT),治疗期间严密监测患者血糖控制情况,并予饮食指导、低血糖健康教育,鼓励患者积极运动,比较2组患者治疗前后空腹血糖(FBG)、餐后2 h血糖(2h PBG)及糖化血红蛋白(Hb A1c)的变化情况,观察其低血糖事件发生情况和治疗依从性。结果:2组患者治疗后的FBG、2h PBG和Hb A1c均较治疗前显著降低(P<0.05),治疗后观察组患者的FBG、2h PBG和Hb A1c显著低于对照组(P<0.05);观察组患者的低血糖事件发生率与治疗依从性均显著优于对照组(P<0.05)。结论:门诊起始胰岛素疗法可有效控制老年2型糖尿病患者的血糖水平,降低低血糖事件的发生率,提高了患者的治疗依从性。

Objective： To evaluate the clinical efficacy and safety for using out-patients initial insulin therapy in el- derly patients with Type 2 diabetes. Methods： Elderly type 2 diabetes patients with tmsatisfactory blood glucose after taking hypoglycemic drugs orally were randomly divided into treatment group and control group.Patients in control group went on taking Glimepiride Tablets（Amaryl,AML）and Acarbose Tablets（Glucobay, GCB）,while patients in treat- ment group took AML orally every morning and were injected Insulin Detemir（IDT） at 9：30 pm. On treatment, the pa- tients＇ blood glucose was closely monitored, and the patients were given dietary guidance combing hypoglycemia health education. Furthermore the active exercise was encouraged.The patients＇ fasting blood glucose（FBG）, 2-hour postprandi- al blood glucose（2hPBG） and glycosylated hemoglobin（HbAlc） prior and post treatment were compared, and the hypo- glycemic events and treatment compliance were obserbed. Results： All patients＇ FBG, 2 h PBG and HbAlc after therapy decreased significantly than prior treatment.The patients＇ post treatment FBG, 2 h PBG and HbAlc in treatment group were significantly lower those of than the control group（P〈0.05）. Hypoglyeemic events in treatment group were signifi- cantly lower than those of the control group, while treatment compliance in treatment group were significantly higher than those of the control group（P〈0.05）.Conlusion： Outpatient initial insulin therapy can effectively control blood sugar levels in elderly patients with type 2 diabetes ,and reduce the incidence of hypoglycemia. Moreover it can enhance pa- tients＇ treatment compliance, so it is worthy of clinical application extensively.