优泌乐50与甘精胰岛素治疗口服降糖药血糖控制不佳的2型糖尿病患者的效果比较

Effect of humalog mix 50 versus insulin glargine on treating type 2 diabetes mellitus patients with poor blood glucose control by oral administration of hypoglycemic agents

目的探讨口服降糖药(OADs)血糖控制不佳的2型糖尿病(T2DM)患者分别加用优泌乐50和甘精胰岛素的疗效和安全性。方法将OADs血糖控制不佳的77例T2DM患者随机分为2组。加用优泌乐50者为A组(n=38),加用甘精胰岛素者为B组(n=39)。比较2组患者基线资料和治疗24周的空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(Hb A1c)、低血糖事件发生率及体质量增加情况。结果治疗24周后,2组FBG、2 h PBG和Hb A1c均较治疗前显著下降,B组患者FBG下降幅度显著大于A组(P<0.05),但2 h PBG下降幅度显著小于A组(P<0.05);而2组的Hb A1c下降幅度比较,差异无统计学意义(P>0.05)。2组均未发生严重低血糖事件,2组轻度低血糖事件发生率及体质量增加情况比较,差异均无统计学意义(P>0.05)。结论 OADs血糖控制不佳的T2DM患者加用合适剂量的优泌乐50、甘精胰岛素均能有效控制血糖,而优泌乐50对餐后血糖的控制情况优于甘精胰岛素。

Objective To compare the efficacy and safety of humalog mix 50 versus glarine insulin in treating poorly controlled type 2 diabetes mellitus （T2DM） patients with oral antidiabetic drugs（OADs）. Methods A total of 77 poorly controlled T2DM patients with OADs were randomly divided in two groups. The group A （ n =38） was given humalog mix 50, the group B （ n =39） was given glarine insulin. The baseline data of patients and the following indicators including fasting blood glucose （FBG）, 2 h postprandial plasma glucose（2 h PBG）, glycosylated hemoglobin（HbAlc）, the incidence of hypoglycemia and the changes of body weight after treatment for 24 weeks were compared. Results After 24 weeks of treatment, both groups had significantly reduced FBG, 2 h PBG and HbA1c（ P 〈0.05）, but the group A decreased more significantly in FBG, and less in 2 h PBG （ P 〈0.05）. There were no significant difference in decrease degree of HbAlc（ P 〉0.05）. There was no serious hypoglycemia in both groups, and the incidences of mild hypoglycemia and weight gain showed no significant difference（ P 〉0.05）. Conclusion Proper amount of humalog mix 50 and glarine insulin can both control blood glucose for type 2 diabetes mellitus patients, while humalog mix 50 has better efficacy in controlling postprandial plasma glucose than glarine insulin.