赖脯胰岛素与门冬胰岛素治疗胰岛β细胞功能衰竭2型糖尿病的疗效与安全性

Efficacy and Safety of Insulin Lispro and Insulin Aspart in the Treatment of Pancreatic β-cell Failure Type 2 Diabetes

目的探讨对胰岛素β细胞功能衰竭2型糖尿病(T2DM)患者分别采用门冬胰岛素和赖脯胰岛素治疗的临床效果。方法方便选取2020年4—12月该院收治的84例胰岛素β细胞功能衰竭T2DM患者,采用均等单盲法将84例患者分为研究1组和研究2组,各42例。两组患者均给予糖尿病常规指导,研究1组在常规指导基础上给予门冬胰岛素进行治疗,研究2组在常规指导基础上给予赖脯胰岛素进行治疗,对比两组患者临床治疗效果和安全性。结果研究2组治疗前糖化血红蛋白和各阶段血糖水平对比差异无统计学意义(P>0.05);研究2组治疗后空腹、午餐前、晚餐前以及睡前血糖水平高于研究1组,早餐后2 h、午餐后2 h和晚餐后2 h血糖水平低于研究1组,差异有统计学意义(P<0.05)。研究2组治疗前24 h动态血糖指标中平均血糖水平(MBG)、血糖标准差(SDBG)、平均血糖波动幅度(MAGE)、平均餐后血糖波动幅度(MPPGE)、最大血糖波动幅度(LAGE)和日间血糖平均绝对差(MODD)水平与研究1组相比差异无统计学意义(P>0.05);研究2组治疗后MAGE、MPPGE、LAGE和MODD水平均低于研究1组,差异有统计学意义(P<0.05);但两组治疗后MBG、SDBG对比差异无统计学意义(P>0.05)。研究2组低血糖发生率9.52%低于研究1组26.19%,差异有统计学意义(χ^(2)=3.977,P<0.05)。结论对胰岛素β细胞功能衰竭T2DM患者采用赖脯胰岛素治疗可以更好地控制患者的血糖水平,减少血糖水平的大幅度波动和低血糖的发生,临床治疗优势更胜于门冬胰岛素,且安全性高。

Objective To investigate the clinical effects of insulin aspart and insulin lispro in patients with type 2 diabetes mellitus(T2DM)with insulin β-cell failure.Methods 84 cases of insulin treated in the hospital from April to December 2020 were conveniently selected β in T2DM patients with cell failure,84 patients were divided into study group 1 and study group 2 by equal single blind method,with 42 cases in each group,the two groups were given regular guidance on diabetes,the study 1 group was given insulin aspart on the basis of regular guidance,and the study 2 group was given insulin lispro on the basis of regular guidance.The clinical treatment effects and safety of the two groups were compared.Results There was no statistically significant difference in the levels of glycosylated hemoglobin and blood glucose levels between the two groups before treatment(P>0.05);the blood glucose levels of the study 2 groups after treatment,fasting,before lunch,before dinner,and before bedtime were higher than those of the study 1,the blood glucose levels 2 h after breakfast,2 h after lunch,and 2 h after dinner were lower than those of study group 1,and the difference was statistically significant(P<0.05).The average blood glucose level(MBG),standard deviation of blood glucose(SDBG),average blood glucose fluctuation range(MAGE),average postprandial blood glucose fluctuation range(MPPGE),maximum blood glucose fluctuation range(LAGE)and daily mean absolute difference in blood glucose(MODD)level in the study 2 group were compared with the study 1 group before treatment,and was not statistically significant difference(P>0.05);the MAGE,MPPGE,LAGE and MODD levels after treatment in the study 2 group are lower than those in the study 1,and the difference was statistically significant(P<0.05);but the difference between the MBG and SDBG after treatment between the two groups was not statistically significant(P>0.05).The incidence of hypoglycemia in study 2 group was 9.52%lower than that in study 1 group 26.19%,and the difference was statistically significant(χ^(2)=3.977,P<0.05).Conclusion The use of insulin lispro for T2DM patients with insulin β-cell failure can better control the patient's blood glucose level,reduce the large fluctuations in blood glucose level and the occurrence of hypoglycemia.The clinical treatment advantage is better than insulin aspart,and it is safer.