地特胰岛素与甘精胰岛素联合阿卡波糖对2型糖尿病患者的血糖波动影响比较

Effect of Insulin Detemir or Insulin Glargine Combined with Acarbose on Blood Glucose Fluctuation in Patients with Type 2 Diabetes Mellitus

目的比较地特胰岛素与甘精胰岛素联合阿卡波糖对2型糖尿病患者血糖波动的影响。方法选取湖北航天医院2018年12月至2019年12月收治的2型糖尿病患者82例,按随机数字表法分为对照组和观察组,各41例。对照组患者予甘精胰岛素联合阿卡波糖治疗,观察组患者予地特胰岛素联合阿卡波糖治疗,两组均治疗8周。结果治疗后,两组患者的血糖水平(空腹血糖、餐后2 h血糖、糖化血红蛋白)、血糖波动指标(血糖水平标准差、全天有效血糖波动次数、平均血糖波动幅度、空腹血糖变异系数、日间血糖平均绝对差)比较均无明显差异(P>0.05);治疗后,对照组体质量和体质量指数均显著增加,观察组体质量和体质量指数均显著低于对照组(P<0.05);观察组和对照组治疗期间的不良反应发生率相当(17.07%比14.63%,P>0.05)。结论地特胰岛素与甘精胰岛素联合阿卡波糖治疗2型糖尿病均可有效降低患者的血糖水平,控制血糖波动幅度,疗效相当,且不易发生低血糖,但甘精胰岛素联合阿卡波糖可能会引起体质量增加。

Objective To compare the effect of insulin detemir or insulin glargine combined with acarbose on blood glucose fluctuation in patients with type 2 diabetes mellitus(T2DM).Methods A total of 82 patients with T2DM admitted to the hospital from December 2018 to December 2019 were selected and divided into the control group and the observation group according to the random number table,with 41 cases in each group.The patients in the control group were treated with insulin glargine combined with acarbose,while the patients in the observation group were treated with insulin detemir combined with acarbose.Both groups were treated for eight weeks.Results After treatment,there was no significant difference in the blood glucose level[fasting blood glucose(FBG),postprandial 2 h blood glucose(2 hPG),glycosylated hemoglobin(HbA1C)],blood glucose fluctuation indexes[standard deviation of blood glucose(SDBG),number of glycemic excursion(NGE),mean amplitude of glycemic excursions(MAGE),coefficient of variation of fasting blood glucose(CV-FBG),mean of daily differences(MODD)]between the two groups(P>0.05).After treatment,the body mass and body mass index(BMI)in the control group were significantly higher than those before treatment,and those in the observation group were significantly lower than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was similar to that in the control group(17.07%vs.14.63%,P>0.05).Conclusion Both insulin detemir and insulin glargine combined with acarbose can effectively reduce the blood glucose level and control blood glucose fluctuation range of patients with T2DM.The two regimens have the similar effect and have low incidence of hypoglycemia,but insulin glargine combined with acarbose may cause patients'body mass gain.