基础胰岛素联合小檗碱治疗老年2型糖尿病的临床研究

Basal Insulin Combined with Berberine in the Treatment of Type 2 Diabetes Mellitus in Older Patients

目的探究在老年2型糖尿病的治疗中由预混胰岛素转换为基础胰岛素联合小檗碱治疗的临床疗效及其对餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)、空腹血糖(FBG)指标的影响.方法选取2015年6月~2017年5月使用预混胰岛素治疗效果不理想的老年2型糖尿病患者80例,转为基础胰岛素和小檗碱联合治疗的方法,进行为期24周的治疗,仔细观察并记录患者治疗方法转换前后的2hPG、HbA1c、FBG、体质指数(BMI)、腰臀比(WHR)、空腹及餐后2hC肽水平、5点血糖水平等变化情况.结果转换治疗后的2hPG、HbA1c和FBG水平均比转换前降低,其达标率较之前显著提高(P<0.05);HbA1c>7%组与HbA1c≤6.5%组相比,其HbA1c、餐后2hC肽和HbA1c降幅的差异显著(P<0.05);HbA1c>7%水平下的三餐后血糖水平较HbA1c≤6.5%水平下的血糖水平要高(P<0.05).结论在老年2型糖尿病的治疗中由预混胰岛素转换为基础胰岛素联合小檗碱治疗具有较好的临床疗效,能够提高治疗后的血糖达标率,有效改善患者症状,提高患者的治疗满意程度,能够使患者获得更高的生活质量,无明显的不良反应,可以在临床上进行广泛的推广和应用.

Objective To explore the effects of basic insulin combined with berberine on type 2 diabetes mellitus and 2-hour postprandial blood glucose(2hPG),glycosylated hemoglobin(HbA1c)and fasting blood glucose(FBG)in older patients.Methods 80 older type 2 diabetes patients with unsatisfactory therapeutic effect of premixed insulin were enrolled from June 2015 to May 2017.The premixed insulin was replaced with basal insulin plus berberine for 24 weeks in patients.The levels of 2hPG,HbA1c,FBG,body mass index(BMI),waist to hip ratio(WHR),fasting and postprandial 2hC-peptide levels,blood glucose levels at 5 time points were documented.Results The levels of 2hPG,HbA1c and FBG were lower and the control rates increased significantly when treated with basal insulin plus berberine than those when treated with premixed insulin(P<0.05).There were sig-nificant differences in the levels of HbA1c,postprandial 2hC-peptide and the decrease of HbA1c between the patients with HbA1c>7% and the patients with HbA1c≤6.5%(P<0.05).The postprandial blood glucose levels in patients with HbA1c>7% were higher than those in patients with HbA1c≤6.5%(P<0.05).Conclusion Basal insulin combined with berberine exhibits good therapeutic effect in older type 2 diabetic patients with unsatisfactory therapeutic effect of premixed insulin.