精蛋白重组人胰岛素混合注射液40/60治疗老年2型糖尿病的疗效及对患者预后的影响

Efficacy of Protamine Recombinant Human Insulin Mix 40/60 in Treating Elderly Patients with Type 2 Diabetes and Its Impact on Prognosis

目的:探讨精蛋白重组人胰岛素混合注射液40/60(简称甘舒霖40/60)治疗老年2型糖尿病(T2DM)的疗效及对患者预后的影响。方法:采用简单随机分组法将西部战区总医院2022年12月至2023年12月收治的106例T2DM患者分为对照组(n=53)和治疗组(n=53)。对照组予常规二联降糖方案治疗(二甲双胍+达格列净),治疗组予甘舒霖40/60皮下注射治疗。12周后评价疗效及安全性,测定两组治疗前、后血糖指标、体重指数(BMI)、胰岛β细胞功能指标及血清单核细胞趋化因子(MCP-1)、超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)水平差异,并统计随访6个月预后。结果:治疗组治疗总有效率为90.57%,较对照组的71.70%更高(P<0.05)。治疗后,与对照组相比,治疗组空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbAlc)、胰岛素抵抗指数(HOMA-IR)及血清MCP-1、hs-CRP、IL-6水平更低,胰岛β细胞功能指数(HOMA-β)更高(P<0.05)。治疗组(3.77%)、对照组(7.55%)总不良反应发生率比较差异无统计学意义(P>0.05);两组随访6个月微血管并发症发生率差异无统计学意义(P>0.05)。结论:采用甘舒霖40/60皮下注射治疗老年T2DM安全有效,不仅能降低患者血糖水平,促进胰岛β细胞功能恢复,减轻炎症反应,但并未改善患者短期预后。

Objective:To explore the efficacy of protamine recombinant human insulin mix 40/60(referred to as Gansulin 40/60)in treating elderly patients with type 2 diabetes(T2DM)and its impact on prognosis.Methods:A total of 106 elderly T2DM patients admitted to Western Theater General Hospital between December 2022 and December 2023 were randomly divided into a control group(n=53)and a treatment group(n=53).The control group received standard dual antidiabetic therapy(metformin+dapagliflozin),while the treatment group was given Gansulin 40/60 subcutaneous injections.After 12 weeks,efficacy and safety were evaluated,and pre-and post-treatment glycemic indicators,body mass index(BMI),β-cell function,and serum levels of monocyte chemoattractant protein-1(MCP-1),high-sensitivity C-reactive protein(hs-CRP),and interleukin-6(IL-6)were measured.The prognosis of both groups was tracked for 6 months.Results:The overall effective rate in the treatment group was 90.57%,higher than that in the control group(71.70%)(P<0.05).After treatment,the treatment group showed lower fasting plasma glucose(FPG),2-hour postprandial glucose(2hPG),glycosylated hemoglobin(HbA1c),homeostasis model assessment of insulin resistance(HOMA-IR),and serum MCP-1,hs-CRP,and IL-6 levels,and higherβ-cell function index(HOMA-β)compared to the control group(P<0.05).The overall incidence of adverse reactions in the treatment group(3.77%)was not significantly different from that in the control group(7.55%)(P>0.05).There was no significant difference in the incidence of microvascular complications between the two groups over the 6-month follow-up period(P>0.05).Conclusion:Subcutaneous injection of Gansulin 40/60 in elderly T2DM patients is safe and effective,lowering blood glucose levels,promotingβ-cell function recovery,and reducing inflammation,though it does not significantly improve short-term prognosis.