探讨三加一联合强化胰岛素治疗2型糖尿病的疗效及安全性的临床研究

A Clinical Study on the Efficacy and Safety of Three Plus One Combined with Intensive Insulin in the Treatment of Type 2 Diabetes Mellitus

目的分析2型糖尿病(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月常熟市沙家浜卫生院门诊就诊的T2DM患者60例作为研究对象,按照随机数表法,将其分成观察组(n=30)、对照组(n=30),其中对照组实施早、晚餐门冬30胰岛素进行治疗,观察组则采取三加一联合强化甘精胰岛素治疗,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。结果治疗后,观察组血糖、糖化血红白蛋白水平均低于对照组,差异有统计学意义(P<0.05);治疗后,观察组血糖达标各项指标均优于对照组,差异有统计学意义(P<0.05);观察组胰岛素用量(31.24±6.28)U/d,少于对照组的(37.83±5.12)U/d,且低血糖发生率为3.33%,血糖达标时间(6.13±0.67)d,明显低于对照组20.00%、(6.92±0.49)d,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,且所需胰岛素用量较低,尚未增加用药风险,治疗效果确切。

Objective To analyze the efficacy and safety of three plus one combined with intensive insulin therapy for type 2 diabetes mellitus(T2DM).Methods A total of 60 T2DM patients who visited the outpatient clinic of Changshu Shajiabang Health Center from July 2020 to July 2021 were selected as the research subjects.According to the random number expression method,they were divided into observation group(n=30)and control group(n=30).The control group was treated with insulin aspart 30 in the morning and dinner,and the observation group was treated with three plus one combined with intensive insulin glargine treatment for 2 weeks.After treatment,the levels of blood glucose and glycosylated hemoglobin in the two groups were compared.The 2 d blood glucose fluctuation indexes were compared between the two groups after the blood glucose reached the standard.The insulin dosage,the occurrence of hypoglycemia and the time to reach the blood glucose time were compared between the two groups.Results After treatment,the levels of blood glucose and glycosylated hemoglobin in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).After treatment,the blood glucose up-tostandard indicators in the observation group were better than those in the control group,with statistical significant differences(P<0.05).The insulin dosage of the observation group was(31.24±6.28)U/d,which was less than that of the control group(37.83±5.12)U/d.The incidence rate of hypoglycemia was,3.33%,and the time to reach the blood glucose standard was(6.13±0.67)d,which was significantly lower than that of the control group[20.00%,(6.92±0.49)d],and the difference was statistically significant(P<0.05).Conclusion Three plus one combined with intensive insulin in the treatment of T2DM can control blood glucose stability in a relatively short period of time,and the amount of insulin required is low,and the risk of drug use has not been increased,and the therapeutic effect is definite.