“3+1”方案与预混胰岛素治疗2型糖尿病的临床比较

Clinical Comparison of"3+1"Regimen and Premixed Insulin in the Treat⁃ment of Type 2 Diabetes Mellitus

目的分析2型糖尿病应用“3+1”方案与预混胰岛素治疗的临床效果。方法选取2022年8月—2023年8月滨州医学院附属医院全科医学科收治的88例2型糖尿病患者为研究对象,根据治疗方法不同分为参照组与观察组,各44例。参照组给予预混胰岛素治疗,观察组给予“3(早、中、晚餐前门冬胰岛素30皮下注射)+1(睡前甘精胰岛素皮下注射)”方案治疗,对比两组血糖指标[空腹血糖(fasing plasma glucose,FPG)、餐后2 h血糖(2-hour postprandial plasma glucose,2 hPG)、糖化血红蛋白(glycated hemoglobin A1c,HbAlc)]水平、血糖波动情况[血糖水平标准差(standard deviation of blood glucose level,SDBG)、餐后血糖波动幅度(postprandial glu-cose fluctuation amplitude,PPGE)、四分位血糖波动范围(interquartile range of glucose fluctuation,IQR)、变异系数(coefficient of variation,CV)]、血糖达标时间、胰岛素用量、低血糖发生率。结果治疗后,两组血糖水平均低于治疗前,且观察组低于参照组,差异有统计学意义(P均<0.05)。相较于治疗前,两组治疗后SDBG、PPGE、IQR均降低,CV增大,且与参照组比较,观察组治疗后SDBG、PPGE、IQR更低,CV更大,差异有统计学意义(P均<0.05)。观察组胰岛素用量少于参照组,血糖达标时间短于参照组,差异有统计学意义(P均<0.05)。观察组低血糖发生率低于参照组,差异有统计学意义(P<0.05)。结论“3+1”方案治疗2型糖尿病的临床效果优于预混胰岛素,能够降低血糖水平,加快降低血糖水平,安全性高。

Objective To analyze the clinical effects of"3+1"regimen and premixed insulin in the treatment of type 2 diabetes mellitus.Methods From August 2022 to August 2023,a total of 88 patients with type 2 diabetes mellitus ad-mitted to the general practice department of Binzhou Medical University Hospital were selected as the research ob-jects.According to different treatment methods,they were divided into reference group and observation group,44 cases in each group.The reference group was treated with premixed insulin,and the observation group was treated with"3(subcutaneous injection of insulin aspart 30 before breakfast,lunch and dinner)+1(subcutaneous injection of insulin glargine before bedtime)".The levels of blood glucose indicators[fasing plasma glucose(FPG),2-hour post-prandial plasma glucose(2 hPG),glycated hemoglobin A1c(HbAlc)],blood glucose fluctuations[standard deviation of blood glucose level(SDBG),postprandial glucose fluctuation amplitude(PPGE),interquartile range of glucose fluctua-tion(IQR),coefficient of variation(CV)],blood glucose compliance time,insulin dosage and incidence of hypoglyce-mia were compared between the two groups.Results After treatment,the blood glucose levels of the two groups were lower than those before treatment,and the observation group was lower than the reference group,and the differences were statistically significant(all P<0.05).Compared with before treatment,the SDBG,PPGE and IQR of the two groups decreased,and the CV was increased after treatment,compared with the reference group,SDBG,PPGE and IQR were lower and CV was larger in the observation group after treatment,and the differences were statistically sig-nificant(all P<0.05).The dosage of insulin in the observation group was less than that in the reference group,and the time of blood glucose reaching the standard was shorter than that in the reference group,and the differences were sta-tistically significant(both P<0.05).The incidence of hypoglycemia in the observation group was lower than that in the reference group,and the difference was statistically significant(P<0.05).Conclusion The clinical effect of"3+1"regi-men in the treatment of type 2 diabetes mellitus is better than that of premixed insulin,which can reduce the blood glucose level,accelerate the reduction of blood glucose level,with high safety and more prominent advantages.