德谷门冬双胰岛素治疗口服降糖药效果不佳的2型糖尿病疗效观察

Therapeutic effects of insulin degludec/insulin aspart on type 2 diabetes mellitus in patients with poor efficacy of oral hypoglycemic drugs

目的观察德谷门冬双胰岛素治疗口服降糖药效果不佳的2型糖尿病的临床疗效与安全性。方法选取重庆能投健康产业有限公司天府医院2020年8月至2021年8月收治的口服降糖药治疗效果不佳的2型糖尿病患者100例,采用随机数字表法分为对照组、观察组各50例。观察组给予德谷门冬双胰岛素联合二甲双胍治疗,对照组给予门冬胰岛素30联合二甲双胍治疗,两组疗程3个月。观察两组治疗前后空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbAlc)的变化及临床疗效。结果治疗后,观察组完成疗程48例,对照组46例。观察组FPG、2hPG分别为(6.24±1.12)mmol/L、(8.34±2.34)mmol/L,均明显低于对照组的(6.91±1.86)mmol/L、(10.72±2.48)mmol/L,差异均有统计学意义(t=3.28、4.76,均P<0.05);两组HbAlc差异无统计学意义(P>0.05)。观察组低血糖发生率为2%(1/48),对照组为13%(6/46),两组差异有统计学意义(χ^(2)=4.09,P<0.05)。观察组胰岛素日剂量为(13.5±2.8)IU,少于对照组的(15.6±3.1)IU(t=3.28,P<0.05)。结论与门冬胰岛素30比较,德谷门冬双胰岛素治疗口服降糖药物效果不佳的2型糖尿病,可明显降低FPG、2hPG,低血糖发生率更低,胰岛素日剂量更少。

Objective To investigate the clinical efficacy of insulin degludec/insulin aspart on type 2 diabetes mellitus in patients with poor efficacy of oral hypoglycemic drugs.Methods A total of 100 patients with type 2 diabetes mellitus in Tianfu Hospital of Chongqing Energy Investment Health Industry Company Limited from August 2020 to August 2021 were included in this study.They were randomly assigned to receive either insulin degludec/insulin aspart combined with Metformin(observation group,n=50)or nsulin aspart 30 injection and Metformin(control group,n=50).All patients were treated for 3 months.Changes in fasting plasma glucose level,2-hour postprandial glucose level,and HbAlc after treatment relative to those before treatment as well as clinical efficacy were determined in each group.Results Forty-eight patients in the observation group and forty-six patients in the control group completed the course of treatment.Fasting blood glucose level and 2-hour postprandial glucose level in the observation group were(6.24±1.12)mmol/L and(8.34±2.34)mmol/L,respectively and they were significantly lower than(6.91±1.86)mmol/L and(10.72±2.48)mmol/L,respectively in the control group(t=3.28,4.76,both P<0.05).The level of HbAlc was not significant between the two groups(P>0.05).The hypoglycemia rate in the observation group was significantly lower than that in the control group[2%(1/48)vs.13%(6/46),χ^(2)=4.09,P<0.05].The daily dose of insulin in the observation group was less than that in the control group[(13.5±2.8)IU vs.(15.6±3.1)IU,t=3.28,P<0.05)].Conclusion Compared with insulin insulin aspart 30,the insulin degludec/insulin aspart has a stronger hypoglycemic effect on fasting plasma glucose level and 2-hour postprandial glucose level in the treatment of type 2 diabetes mellitus in patients with poor efficacy of oral hypoglycemic drugs,leading to a less daily dose of insulin.