艾塞那肽联合门冬胰岛素控制血糖疗效分析

Effect analysis on exenatide combined with insulin aspart in blood glucose control

目的分析肥胖症合并2型糖尿病的确诊患者通过应用艾塞那肽注射液联合门冬胰岛素注射液控制血糖和体重指数的临床综合效果,及缩短血糖达标所需的时间。方法对我院2014年6月~2015年6月确诊为2型糖尿病且体重指数(BMI)>28 kg/m^2的住院患者100例,随机分为对照组和观察组;两组基础治疗的方法均为门冬胰岛素注射液连续皮下注射日基础量,对照组在基础治疗的同时给予阿卡波糖片50 mg,每日3次,餐时嚼服;观察组在基础治疗的基础上应用艾塞那肽注射液5μg皮下注射每日2次。两组均给予监测指端血糖每日8次。患者住院治疗30 d后观察血糖总体控制情况,综合评估疗效。结果观察组的治疗后血糖控制总体优于对照组,差异有统计学意义(P<0.05);观察组糖化血红蛋白与体重指数治疗后均优于对照组,差异有高度统计学意义(P<0.01),两组均未发生严重低血糖病例,观察组的血糖达标时间较对照组显著缩短,差异有高度统计学意义(P<0.01),观察组的胰岛素用量小于对照组,差异有高度统计学意义(P<0.01)。结论肥胖症合并2型糖尿病患者采用艾塞那肽注射液联合门冬胰岛素注射液控制血糖可使血糖达标率增高,体重指数稳中有降,血糖达标时间缩短,让患者最大限度受益,血糖达标的同时避免了体重增加的弊端,减少和防止了糖尿病并发症的发生,较口服阿卡波糖片联合门冬胰岛素注射液疗效显著,安全可靠,值得临床推广。

Objectives To analyze the clinical effect of exenatide injection combined with insulin aspart injection in controlling of blood glucose and weight indices and the reaching-standard time of blood glucose among 50 patients with obesity and type Ⅱ diabetes. Methods A total of 100 patients diagnosed as type Ⅱ diabetes with BMI 28 kg/m^2 treated in our hospital from June 2014 to June 2015 were selected and randomly divided into the control group and the observation group. Patients in both groups were treated by daily insulin aspart injection continuous and subcutaneous basal therapy. Patients in the control group were additionally given acarbose tablet 50 mg, tid, chewing at meals; while patients in the observation group were additionally given exenatide subcutaneous injection, 5 μg, bid. Blood glucose of patients in both groups were monitored through finger tips for eight times per day. The overall control of blood glucose and curative effect were assessed after 30 days of hospitalization. Results The blood glucose control in general of observation group after treatment was better than the control group, the difference was statistically significant（P〈0.05）; glycosylated hemoglobin and body mass index（BMI） of observation group were better than control group after treatment,the difference was statistically significant（P〈0.01）, two groups were not cases of severe hypoglycemia, the time of blood glucose control of observation group was significantly shortened, the difference was statistically significant（P〈0.01）, the insulin dosage of observation group was less than the control group, the difference was statistically significant（P〈0.01）.Conclusion Exenatide subcutaneous injection combined with insulin aspart injection can increase the rate of reaching the standard of blood glucose among patients with obesity and type Ⅱ diabetes, and can keep the weight of patients stable with a slight decline, shorten the reaching-standard time, and benefit the patients to the maximum limit that effectively controlling blood glucose and avoiding gaining weight, as well as reducing the incidence of diabetic complications. Compared with oral administration of acarbose tablet combination of insulin aspart injection has more significant effectiveness and accredited safety, which is worthy to be promoted.