德谷门冬双胰岛素与基础-餐时胰岛素短期强化治疗对新诊断2型糖尿病血糖控制的影响

Effect of IDegAsp and basal-bolus insulin short-term intensive therapy for blood glucose control in newly diagnosed type 2 diabetes mellitus

目的探讨德谷门冬双胰岛素(IDegAsp)2次/d与基础-餐时胰岛素4次/d注射方案对新诊断T2DM BG控制的影响。方法选取2020年1月至2021年4月于安徽医科大学第一附属医院内分泌科门诊或住院治疗的新诊断T2DM患者60例,佩戴扫描式葡萄糖监测仪(FGM)1周后随机分为IDegAsp组及基础-餐时胰岛素(BB)组,每组各30例,强化治疗3周后再次佩戴FGM 1周。结果胰岛素强化治疗4周后IDegAsp组葡萄糖目标范围内时间(TIR)高于BB组(P<0.05),葡糖糖波动水平(IQR)、低血糖持续时间(HopD)及低血糖发生率低于BB组(P<0.05)。Pearson相关分析显示,△TIR与△FPG、△2 hPG、△IQR、△平均葡萄糖值呈正相关(P<0.05),与△HpoD呈负相关(P<0.05)。多元线性回归分析结果显示,△IQR、△HpoD是△TIR的影响因素。结论新诊断T2DM患者IDegAsp 2次/d优于基础-餐时胰岛素4次/d注射方案,具有减少低血糖风险、降低BG波动的优势。

Objective To investigate the effects of IDegAsp twice a day and basal-bolus insulin four times a dayintensive therapy in newly diagnosed type 2 diabetes mellitus(T2DM).MethodsFrom January2020 to April 2021,60 patients with newly diagnosed T2DM were selected from the Department of Endocrinology,The First Affiliated Hospital of Anhui Medical University.After 1 week of flash glucose monitoring(FGM),these T2DM patients were randomly divided into IDegAsp group(n=30)and basal-bolus insulin(BB)group(n=30)to receive intensive treatment for 4 weeks.FGM was performed again at week 4 of intensive treatment.ResultsAfter 4 weeks of intensive insulin therapy,the time within the target range(TIR)of glucose in IDegAsp group was higher than that in BB group(P<0.05).The glucose fluctuation level(IQR),the duration of hypoglycemia(HopD)and the incidence of hypoglycemia in IDegAsp group were lower than that in BB group(P<0.05).Pearson correlation analysis showed that△TIR was positively correlated with△FPG,△2 h PG,△IQR and△MBG(P<0.05),and negatively correlated with△HopD(P<0.05).Multiple linear regression analysis showed that△IQR and△HopD were the influencing factors of△TIR.ConclusionIDegAsp 2 times/d injection regimen is more effective than basal-bolus 4 times/d injection regimen in newly diagnosed T2DM patients,with the advantages of lower risk of hypoglycemia and less blood glucose fluctuations.