三加一联合强化胰岛素治疗2型糖尿病的疗效及安全性研究

Clinical study on efficacy and safety of three plus one combined intensive insulin therapy for type 2 diabetes mellitus

目的观察2型糖尿病(diabetes mellitus type 2,T2DM)采取三加一联合强化胰岛素治疗的疗效和安全性。方法选取2020年7月—2021年7月信阳市中心医院收治的60例T2DM患者,根据治疗药物不同,将实施早、晚餐门冬30胰岛素进行治疗的30例作为对照组,将采取三加一联合强化甘精胰岛素治疗的30例作为观察组,均治疗2周。治疗结束后比较两组血糖、糖化血红白蛋白水平;对比两组血糖达标后2 d血糖波动指标;统计两组胰岛素用量、低血糖发生情况及血糖达标时间数值。结果治疗后,观察组空腹血糖(FBG)、餐后2 h血糖、糖化血红蛋白分别为(5.06±1.12)mmol/L、(7.13±1.12)mmol/L及(6.55±0.94)%,均低于对照组(P<0.05);观察组血糖水平标准差(SDBG)、四分位血糖波动范围(IQR)和餐后血糖波动幅度(PPGE)分别为(2.38±0.76)mmol/L、(2.71±0.56)mmol/L及(3.56±0.94)mmol/L,均低于对照组,而变异系数(CV)数值高于对照组,差异有统计学意义(P<0.05);观察组胰岛素用量少于对照组,血糖达标时间短于对照组,低血糖发生率(3.33%)优于对照组(20.00%),差异有统计学意义(P<0.05)。结论三加一联合强化胰岛素治疗T2DM可在较短时间内控制血糖稳定,且所需胰岛素用量少,尚未增加用药风险,治疗效果确切。

Objective To observe the efficacy and safety of three plus 2 combined intensive insulin therapy in diabetes mellitus type 2(T_(2)DM).Methods Totally 60 patients with T_(2)DM in our clinic from July 2020 to July 2021 were selected as the research object.According to the random number expression,they were divided into two groups:observation group(n=30)and control group(n=30).The control group was treated with insulin asparagus 30 in the morning and dinner,and the observation group was treated with three plus one combined with intensive insulin glargine for 2 weeks.After treatment,the levels of blood glucose and glycosylated blood red albumin were compared between the two groups;The blood glucose fluctuation indexes of the two groups after reaching the standard of blood glucose were compared;The insulin dosage,hypoglycemia and blood glucose standard time of the two groups were counted.Results After treatment,FBG,2 h postprandial blood glucose and glycated hemoglobin in the observation group were(5.06±1.12)mmol/L,(7.13±1.12)mmol/L and(6.55±0.94)%,respectively,lower than those in the control group(P<0.05).SDBG,IQR and PPGE of the observation group were(2.38±0.76)mmol/L,(2.71±0.56)mmol/L and(3.56±0.94)mmol/L,respectively,lower than those of the control group,while CV value was higher than that of the control group,the difference was statistically significant(P<0.05).The incidence of hypoglycemia in the observation group(3.33%)was better than that in the control group(20.00%),and the difference was statistically significant(P<0.05).Conclusion Three plus one combined with intensive insulin in the treatment of T_(2)DM can control blood glucose and stabilize in a short time,and the amount of insulin required is small and low,which has not increased the risk of medication,and the treatment effect is accurate.