Comparison of virus-capsid mimicking biologic-shell based versus polymeric-shell nanoparticles for enhanced oral insulin delivery

Virus-capsid mimicking mucus-permeable nanoparticles are promising oral insulin carriers which surmount intestinal mucus barrier.However,the impact of different viruscapsid mimicking structure remains unexplored.In this study,utilizing biotin grafted chitosan as the main skeleton,virus-mimicking nanoparticles endowed with biologicshell(streptavidin coverage)and polymeric-shell(hyaluronic acid/alginate coating)were designed with insulin as a model drug by self-assembly processes.It was demonstrated that biologic-shell mimicking nanoparticles exhibited a higher intestinal trans-mucus(>80%,10 min)and transmucosal penetration efficiency(1.6–2.2-fold improvement)than polymeric-shell counterparts.Uptake mechanism studies revealed caveolae-mediated endocytosis was responsible for the absorption of biologic-shell mimicking nanoparticles whereas polymeric-shell mimicking nanoparticles were characterized by clathrin-mediated pathway with anticipated lysosomal insulin digestion.Further,in vivo hypoglycemic study indicated that the improved effect of regulating blood sugar levels was virus-capsid structure dependent out of which biologic-shell mimicking nanoparticles presented the best performance(5.1%).Although the findings of this study are encouraging,much more work is required to meet the standards of clinical translation.Taken together,we highlight the external structural dependence of virus-capsid mimicking nanoparticles on the mucopenetrating and uptake mechanism of enterocytes that in turn affecting their in vivo absorption,which should be pondered when engineering virus-mimicking nanoparticles for oral insulin delivery.

The upregulated intestinal folate transporters direct the uptake of ligand-modified nanoparticles for enhanced oral insulin delivery

Transporters are traditionally considered to transport small molecules rather than large-sized nanoparticles due to their small pores.In this study,we demonstrate that the upregulated intestinal transporter(PCFT),which reaches a maximum of 12.3-fold expression in the intestinal epithelial cells of diabetic rats,mediates the uptake of the folic acid-grafted nanoparticles(FNP).Specifically,the upregulated PCFT could exert its function to mediate the endocytosis of FNP and efficiently stimulate the traverse of FNP across enterocytes by the lysosome-evading pathway,Golgi-targeting pathway and basolateral exocytosis,featuring a high oral insulin bioavailability of 14.4%in the diabetic rats.Conversely,in cells with relatively low PCFT expression,the positive surface charge contributes to the cellular uptake of FNP,and FNP are mainly degraded in the lysosomes.Overall,we emphasize that the upregulated intestinal transporters could direct the uptake of ligand-modified nanoparticles by mediating the endocytosis and intracellular trafficking of ligand-modified nanoparticles via the transporter-mediated pathway.This study may also theoretically provide insightful guidelines for the rational design of transporter-targeted nanoparticles to achieve efficient drug delivery in diverse diseases.

Preparation and Evaluation of Insulin-loaded Nanoparticles based on Hydroxypropyl-β-cyclodextrin Modified Carboxymethyl Chitosan for Oral Delivery

Novel insulin-loaded nanoparticles based on hydroxypropyl-β-cyclodextrin modified carboxymethyl chitosan（CMC-HP-β-CD） were prepared to improve the oral bioavailability of insulin. The CMC-HP-β-CD was characterized by FT-IR spectroscopy and 1H-NMR spectra. The insulin-loaded nanoparticles were prepared through crosslinking with calcium ions, and the morphology and size of the prepared nanoparticles were characterized by transmission electron microscopy（TEM） and dynamic light scattering（DLS）. Cumulative release in vitro study was performed respectively in simulated gastric medium fluid（SGF, p H=1.2）, simulated intestinal fluid（SIF, p H=6.8） and simulated colonic fluid（SCF, p H=7.4）. The encapsulation efficiency of insulin was up to 87.14 ± 4.32% through high-performance liquid chromatography（HPLC）. Statistics indicated that only 15% of the encapsulated insulin was released from the CMC-HP-β-CD nanoparticles in 36 h in SGF, and about 50% of the insulin could be released from the nanoparticles in SIF, whereas more than 80% was released in SCF. In addition, the solution containing insulin nanoparticles could effectively reduce the blood glucose level of diabetic mice. The cytotoxicity test showed that the samples had no cytotoxicity. CMC-HP-β-CD nanoparticles are promising candidates as potential carriers in oral insulin delivery systems.

Overcoming oral insulin delivery barriers： application of cell penetrating peptide and silica-based nanoporous composites

Oral insulin delivery has received the most attention in insulin formulations due to its high patient compliance and, more importantly, to its potential to mimic the physiologic insulin secretion seen in non-diabetic individuals. However, oral insulin delivery has two major limitations： the enzymatic barrier that leads to rapid insulin degradation, and the mucosal barrier that limits insulin＇s bioavailability. Several approaches have been actively pursued to circumvent the enzyme barrier, with some of them receiving promising results. Yet, thus far there has been no major success in overcoming the mucosal barrier, which is the main cause in undercutting insulin＇s oral bioavailability. In this review of our group＇s research, an innovative silica-based, mucoadhesive oral insulin formulation with encapsulated-insulin/cell penetrating peptide （CPP） to overcome both enzyme and mucosal barriers is discussed, and the preliminary and convincing results to confirm the plausibility of this oral insulin delivery system are reviewed. In vitro studies demonstrated that the CPPinsulin conjugates could facilitate cellular uptake of insulin while keeping insulin＇s biologic functions intact. It was also confirmed that low molecular weight protamine （LMWP） behaves like a CPP peptide, with a cell translocation potency equivalent to that of the widely studied TAT. The mucoadhesive properties of the produced silica-chitosan composites could be controlled by varying both the pH and composition; the composite consisting of chitosan （25wt-%） and silica （75 wt-%） exhibited the greatest mucoadhesion at gastric pH. Furthermore, drugrelease from the composite network could also be regulated by altering the chitosan content. Overall, the universal applicability of those technologies could lead to development of a generic platform for oral delivery of many other bioactive compounds, especially for peptide or protein drugs which inevitably encounter the poor bioavailability issues.

Oral delivery of insulin with Desmodium gangeticum root aqueous extract protects rat hearts against ischemia reperfusion injury in streptozotocin induced diabetic rats

Objective:To evaluate the effect of insulin administered via oral route with the help of aqueous extract of Desmodium gangeticum(DG) root in rendering cardio protection against ischemia reperfusion injury in diabetic rats.Methods:Diabetes mellitus was induced in rats by theβ-cell toxin,streptozotocin(STZ,60 mg/kg).Isolated rat(IR) heart was used to investigate the effect of insulin mixed DG pretreatment on ischemia reperfusion injury.Mitochondrial respiratory enzymes and microsomal enzymes were used to assess the metabolic recovery of myocardium. Cardiac marker enzymes were used to find the functional recovery,which were compared with that of the STZ treated IR rats.Results:Compared with IR control group,rat treated with insulin mixed DG showed a significant functional and metabolic recovery of myocardium from the insult of ischemia reperfusion.Even though orally administered insulin mixed DG displayed a slow but prolonged hypoglycemic effect,the cardio protection it provided was more significant than when it was given intra peritoneal.Furthermore the above result indicates that insulin mixed DG can overcome the barriers in the gastrointestinal tract and be absorbed.Conclusions:The above results indicate the efficacy of insulin mixed DG in protecting the heart from ischemia reperfusion induced injury in diabetic rats.Furthermore the study gives additional information that herbal extracts can be used to transport insulin across the membrane and found to be a feasible approach for developing the oral delivery of insulin,as well as other peptide drugs.

甘精胰岛素U300联合口服降糖药治疗2型糖尿病的临床效果观察

目的探讨甘精胰岛素U300联合口服降糖药治疗2型糖尿病的临床效果。方法选择2021年10月—2023年1月广东省吴川市人民医院收治的79例2型糖尿病患者,随机分为非甘精组(39例)和U300组(40例)。非甘精组口服降糖药物治疗,在此之上,U300组增加甘精胰岛素U300治疗,持续治疗3个月,对比2组血糖及相关指标变化,并监测患者胰岛素功能相关指标改善情况,评估低血糖反应等不良反应情况。结果治疗后,U300组血糖指标、血糖波动指标均显著低于非甘精组,差异有统计学意义(P<0.05)。U300组治疗后胰岛素功能指标均显著优于非甘精组,空腹及餐后2 h C肽均显著高于非甘精组,差异有统计学意义(P<0.05)。U300组低血糖反应发生率(2.50%,1/40)和不良反应总发生率(20.00%,8/40)与非甘精组(2.56,1/39;17.95%,7/39)比较,差异无统计学意义(P>0.05)。结论增加甘精胰岛素U300治疗,可更好地提升患者血糖管理效果,并可改善胰岛功能,有利于稳定控制血糖,有助于提高患者病情控制效果,应用效果安全可靠。

镁补充改善糖尿病患者血清胰岛素水平的Meta分析

系统评价口服镁补充改善糖尿病患者血清胰岛素水平的效果。采用计算机检索PubMed、EBSCO、The Cochrane Library、CNKI、Web of Science数据库,搜集口服镁补充改善糖尿病患者血清胰岛素水平的相关研究,独立筛查文献、提取资料并评价纳入研究的偏倚风险后采用R studio软件进行Meta分析。亚组分析结果显示,口服镁补充在镁缺乏糖尿病患者中[SMD=-0.29,95%CI(-1.07,0.48),P>0.01]、4~6周补充周期[SMD=-0.74(-1.69,0.20),P>0.01]、250~300 mg/d剂量[SMD=-63(-1.25,0),P<0.01]改善血清胰岛素水平效果更佳,说明口服镁补充对于改善糖尿病患者血清胰岛素水平具有良好的效果。

促胰岛素分泌肽融合蛋白对T2DM患者胰岛素敏感性改善研究

目的:为了定量考察促胰岛素分泌肽融合蛋白(exendin-4-IgG4-Fc,E4F4)给予12周对2型糖尿病(type 2 diabetes mellitus,T2DM)患者胰岛素敏感性的改善情况,本研究拟在E4F4给药前及给药后的标准面餐耐量试验(meal tolerance test,MTT)数据基础上,建立E4F4群体口服葡萄糖微小模型,分析低剂量(2.7 mg)给药12周是否可显著改善2型糖尿病患者的胰岛素敏感性。方法:收集本研究16位受试者中给药前或给药后完成MTT的血糖、胰岛素浓度值,采用NONMEN 7.2软件以非线性混合效应模型分别对给药前后数据进行群体口服葡萄糖微小模型的构建,以获得给药前后胰岛素敏感性参数(insulin sensitive,IS)值,使用GraphPad Prism 8.0对给药前后IS值进行统计学分析,以观察该药对胰岛素敏感性的改善作用。结果:将给药前后IS进行非参数检验,显示给药前后IS差异具有统计学意义(P=0.02),给药后胰岛素敏感性显著高于给药前的基线值。结论:E4F4低剂量治疗2型糖尿病患者12周后,患者胰岛素敏感性得到了改善,可为该全新生物制剂药效提供参考。

靶向纳米载体用于口服胰岛素递送的研究进展

皮下注射胰岛素主要用于治疗糖尿病,但存在局限性。虽然口服胰岛素作为简便的给药方式,能降低副作用、提高患者的依从性;但是蛋白类药物口服后会被胃肠道酶解失活。随着纳米技术的快速发展,靶向纳米递送体系被广泛用于口服胰岛素的研究。其通过与肠细胞表面的受体进行配体-受体特异性结合,增强胰岛素的肠道吸收来提高降血糖作用。本文基于靶向纳米载体的作用机理及主要影响因素,综述了用于口服胰岛素递送的靶向纳米载体的最新进展。

甲状腺功能亢进症患者治疗前后血糖波动及胰岛素分泌特征的临床研究

目的采用动态监测系统评估甲状腺功能亢进症(以下简称甲亢)患者治疗前后血糖波动并观察胰岛素分泌的改变。方法选取江苏省南通市海门区人民医院确诊的30例甲亢患者,葡萄糖耐量试验、胰岛素释放试验及动态血糖监测,比较治疗前后患者血糖波动及评估胰岛素水平及胰岛素抵抗指数。结果甲亢治疗前,女性患者日间血糖波动幅度、最大血糖波动幅度、日间血糖平均绝对差、血糖标准差水平明显低于男性患者(P<0.05)。甲亢治疗后患者餐后1 h葡萄糖、餐后1 h胰岛素、餐后2 h胰岛素和胰岛素抵抗指数、血糖波动幅度(日间平均血糖度、最大血糖度、日间血糖平均绝对差、餐后血糖曲线下面积)低于治疗前(P<0.05)。结论甲亢患者的血糖波动较大,以餐后血糖升高为主,并发生胰岛素抵抗,且男性甲亢患者血糖波动更为显著。甲亢患者在经治疗后胰岛素抵抗程度、餐后血糖和血糖变异性等随着甲状腺功能的恢复而改善。

Brugmann评分预测妊娠期糖尿病孕妇产前胰岛素治疗需求的应用价值

目的 探讨Brugmann评分预测妊娠期糖尿病(GDM)孕妇产前胰岛素治疗需求的应用价值。方法 选择2021年1月—2023年1月丽水市人民医院妇产科的GDM孕妇206例,根据产前是否应用胰岛素治疗分为产前胰岛素治疗组(35例)和非产前胰岛素治疗组(171例)。获取孕妇临床资料以及孕期血糖相关指标,应用Brugmann-口服葡萄糖耐量试验(OGTT)评分和Brugmann-空腹血糖(FBG)评分两个独立评分进行评估。结果 产前胰岛素治疗组孕前体质量指数(BMI),三酰甘油、FBG、1 h OGTT、2 h OGTT、血红蛋白(HbA1c)水平,Brugmann-OGTT评分及Brugmann-FBG评分分别为(24.53±2.81)kg/m^(2)、(3.70±0.71)mmol/L、(6.75±1.83)mmol/L、(11.46±2.10)mmol/L、(10.09±2.11)mmol/L、(5.61±0.70)%、(6.75±2.55)分、(4.86±2.08)分;非产前胰岛素治疗组孕前BMI、三酰甘油、FBG、1 h OGTT、2 h OGTT、HbA1c水平,Brugmann-OGTT评分及Brugmann-FBG评分分别为(23.10±2.17)kg/m^(2)、(2.93±0.66)mmol/L、(6.01±1.76)mmol/L、(9.18±1.83)mmol/L、(8.16±1.16)mmol/L、(5.18±0.35)%、(3.84±1.26)分、(3.18±1.55)分。两组上述指标比较差异均有统计学意义(均P<0.05)。多因素logistic回归分析结果显示:三酰甘油(OR=2.796)、Brugmann-OGTT评分(OR=4.163)、Brugmann-FBG评分(OR=2.538)是GDM孕妇产前胰岛素治疗需求的独立影响因素(均P<0.05)。受试者工作特征(ROC)曲线显示:Brugmann-OGTT评分、Brugmann-FBG评分以及两评分联合预测GDM孕妇产前胰岛素治疗需求的曲线下面积分别为0.873、0.802、0.889。结论 Brugmann-OGTT评分和Brugmann-FBG评分可较好地预测GDM孕妇产前胰岛素治疗需求,适宜在临床推广,用于优化GDM孕妇血糖控制方案和患者管理。

浅谈胰岛素泵在糖尿病患者口腔颌面外科围术期中的作用

目的探讨胰岛素泵在糖尿病患者口腔颌面外科围术期中的作用。方法回顾性选取2022年1—12月潍坊内分泌与代谢病医院口腔科收治的60例糖尿病且接受口腔颌面外科手术患者的临床资料,将30例采用皮下注射胰岛素治疗的患者作为对照组,将30例采用胰岛素泵持续注射胰岛素治疗的患者为观察组。比较两组患者的胰岛β功能指标、血糖控制效果、围术期并发症发生率。结果两组患者术前的胰岛β功能指标比较,差异无统计学意义(P均>0.05)。术后复查时,观察组患者的各项胰岛β功能指标均优于对照组,差异有统计学意义(P均<0.05)。观察组血糖指标和糖化血红蛋白水平低于对照组,差异有统计学意义(P均<0.05)。观察组围术期并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论糖尿病合并口腔颌面外科手术的患者出现创口感染及并发症发生率较高,主要因素包括采取麻醉后产生的不良反应及手术创伤。为稳定控制血糖,应采取胰岛素泵持续皮下注射的方式,降低术后并发症风险,为患者的健康预后奠定基础。

德谷门冬双胰岛素治疗口服降糖药控制不佳2型糖尿病的效果分析

目的分析德谷门冬双胰岛素(Insulin Degludec/Insulin Aspart,IDegAsp)治疗口服降糖药(Oral Antidiabetic Drugs,OADS)控制不佳2型糖尿病的效果。方法选取2022年8月—2023年7月济南市章丘区中医医院收治的92例OADS控制不佳2型糖尿病患者为研究对象,参照随机数表法分为两组,各46例。对照组采用甘精胰岛素治疗,研究组采用IDegAsp治疗。比较两组血糖水平、血糖波动值、低血糖发生率。结果治疗3个月后,研究组糖化血红蛋白、餐后2 h血糖、空腹血糖均低于对照组,差异有统计学意义(P均<0.05);研究组血糖标准差、24 h平均血糖值、餐后血糖波动值均低于对照组,差异有统计学意义(P均<0.05)。研究组血糖达标时间(6.15±1.52)d短于对照组的(7.89±1.60)d,差异有统计学意义(t=5.347,P<0.05)。两组低血糖发生率对比,差异无统计学意义(P>0.05)。结论IDegAsp能够有效改善OADS控制不佳2型糖尿病患者的血糖值,抑制其血糖波动,且未增加低血糖发生风险。

达格列净与降糖药物的联用情况分析

目的探讨辽宁省金秋医院使用达格列净药物的患者年龄、性别分布情况,以及该药与其他降糖药物联用情况,为一线临床人员选用该药物提供临床参考。方法从辽宁省金秋医院中联医院信息(HIS)系统中抽取辽宁省金秋医院2021年4月至2022年7月应用达格列净药物的门诊处方为研究对象进行整理分析。应用Excel进行统计分析患者的年龄、性别,口服达格列净以及达格列净与其他降糖药物联用情况。结果辽宁省金秋医院使用达格列净药物治疗2型糖尿病患者的处方中,男性患者处方714张(71.4%),女性患者处方286张(28.6%),男性患者多于女性患者。该药物在60~74岁年龄组使用比例最高,门诊处方478张(47.8%)。在达格列净与其他口服降糖药物联用的600张处方中,以单用达格列净最多,处方数272张(45.33%),其次是与其他一种口服降糖药联用,处方数238(39.67%),其中与双胍类联用最多,处方数98张(41.18%),与其他两种或者更多种口服降糖药联用较少。在达格列净与胰岛素联用的400张处方中,与中、长效胰岛素联用最多,处方一共352张(88%),与预混胰岛素联用以及与中效和超短效联用的处方数相同,52张处方(13%)。结论辽宁省金秋医院使用达格列净与其它降糖药物联用治疗2型糖尿病患者的用药特点是:达格列净联合中、长效胰岛素控制血糖最多,其次是单用达格列净,如需与其他口服降糖药物联用,多与一种口服降糖药联用,其中与二甲双胍联用最多。

Insulin therapies: Current and future trends at dawn

Insulin is a key player in the control of hyperglycemia for type 1 diabetes patients and selective individuals in patients of type 2 diabetes. Insulin delivery systems that are currently available for the administration of insulin include insulin syringes, insulin infusion pumps, jet injectors and pens. The traditional and most predictable method for the administration of insulin is by subcutaneous injections. The major drawback of current forms of insulin therapy is their invasive nature. To decrease the suffering, the use of supersonic injectors, infusion pumps, sharp needles and pens has been adopted. Such invasive and intensive techniques have spurred the search for alternative, more acceptable methods for administering insulin. Several non-invasive approaches for insulin delivery are being pursued. The newer methods explored include the artificial pancreas with closedloop system, transdermal insulin, and buccal, oral and pulmonary routes. This review focuses on the new concepts that are being explored for use in future.

Vildagliptin-insulin combination improves glycemic control in Asians with type 2 diabetes

AIM: To assess the efficacy and safety of vildagliptin 50 mg bid as add-on therapy to insulin in Asian patients with type 2 diabetes mellitus(T2DM).METHODS: This was a post hoc analysis of a subgroup of Asian patients from a multicenter,randomized,double-blind,placebo-controlled,parallel-group study in T2DM patients inadequately controlled by stable insulin therapy,with or without metformin.A total of 173 patients were randomized 1:1 to receive treatment with vildagliptin 50 mg bid(n = 87) or placebo(n = 86) for 24 wk.Changes in HbA1c and fasting plasma glucose(FPG),from baseline to study endpoint,were analyzed using an analysis of covariance model.Change from baseline to endpoint in body weight was summarized by treatment.Safety and tolerability of vildagliptin was also evaluated.RESULTS: After 24 wk,the difference in adjusted mean change in HbA1c between vildagliptin and placebo was 0.82%(8.96 mmol/mol;P < 0.001) in Asian subgroup,0.85%(9.29 mmol/mol;P < 0.001) in patients also receiving metformin,and 0.73%(7.98 mmol/mol;P < 0.001) in patients without metformin,all in favor of vildagliptin.There was no significant difference in the change in FPG between treatments.Weight was stable in both treatment groups(+0.3 kg and-0.2 kg,for vildagliptin and placebo,respectively).Overall,vildagliptin was safe and well tolerated with similarly low incidences of hypoglycemia(8.0% vs 8.1%) and no severe hypoglycemic events were experienced in either group.CONCLUSION: In Asian patients inadequately controlled with insulin(with or without concomitant metformin),insulin-vildagliptin combination treatment significantly reduced HbA1c compared with placebo,without an increase in risk of hypoglycemia or weight gain.

Insulin Expression in Rats Exposed to Cadmium

To investigate the effects of cadmium exposure on insulin expression in rats. Methods Eighteen adult SD rats were administered cadmium subcutaneously （0.5, 1.0, and 2.0 mg/kg bw）. The effects on endocrine of pancreas were assessed. The levels of cadmium and zinc in pancreas, blood and urine glucose, serum insulin and urine NAG （N-acyetyl-β-glucosaminidase） were determined. The gene expressions of metallothionein （MT） and insulin were also measured, and the oral glucose tolerance tests （OGTT） were carried out. Results The contents of cadmium in pancreas in cadmium-treated rats were higher than that in the control group, which was associated with slight increase of zinc in pancreas. Cadmium-exposed rats （1.0 and 2.0 mg/kg bw） demonstrated a marked glucose intolerance. But the levels of serum insulin did not change significantly after cadmium administration, and the UNAG had no change in Cd-treated group. The gene expression of insulin decreased in 1.0 and 2.0 mg/kg bw cadmium-exposed groups, compared with the control group. The expression of MT-I was higher in the groups exposed to 1.0 and 2.0 mg/kg bw cadmium while the expression of MT-II was higher in the group exposed to 2.0 mg/kg bw cadmium. Conclusions Cadmium may be accumulated in the pancreas, resulting in the change of the expression of insulin, MT-I and MT-Ⅱ genes. Cadmium can influence the biosynthesis of insulin, but does not induce the release of insulin. The dysfunction of pancreas occurs earlier than that of kidney after administration of cadmium.

Preparation of Ionic Liquid Functionalized Silica Nanoparticles for Oral Drug Delivery

The objective of this study is to utilize the pH sensitivity of modified silica nanoparticles (SNIL) by imidazole-based ionic liquid for oral delivery of insulin. In the first time, the imidazole was covalently attached to the 3-trimethoxysily-lpropyl chloride with replacement of all the chlorine atoms. Then, a silica nanoparticle was modified by N-(3-trimeth-oxysilylpropyl) imidazole. The nanocapsule (NCIL) was achieved after the etching of the modified silica nanoparticle template with hydrofluoric acid. The nanoparticles connected through an ionic liquid-like network were characterized by FTIR and SEM. Insulin was entrapped in these carriers and the in vitro release profiles were established separately in both enzyme-free simulated gastric and intestinal fluids (SGF, pH 1) and (SIF, pH 7.4), respectively. When these drug-loaded nanoparticles was placed in physiological buffer solution (pH 7.4), a partial negative surface charge on the modified silica nanoparticle was generated due to the deprotonation of silanol groups, and the strong electrostatic repulsion triggered a sustained release of the loaded molecules.

Alternative routes of insulin delivery

Parenteral route of insulin administration has been the mode of treatment for all Type 1 diabetics and Type 2 diabetics with complications.Patient compliance has really been a major concern for this route of administration.Several alternative routes of administration are under consideration for effective glycemic control,including oral,inhaled,buccal,nasal,and patch routes.One of the approaches involving inhaled insulin has now reached the market.Several other candidates may reach the market in the near future,the promising one being oral insulin.

早期胰岛素强化与口服降糖药治疗老年2型糖尿病的临床疗效分析

目的观察早期胰岛素强化与口服降糖药治疗老年2型糖尿病临床疗效。方法选取2021年1月—2022年1月常州市德安医院收治的82例老年2型糖尿病患者,以随机数表法分组,基础组采用口服降糖药治疗(41例),强化组采取早期胰岛素强化治疗(41例),比较两组血糖指标改善情况、疗效、胰岛素指标。结果强化组患者用药后空腹血糖(FBG)、餐后2 h血糖(2 hPG)及糖化血红蛋白(HbA1c)低于基础组,治疗总有效率显著高于基础组,用药后30 min的C肽/血糖(ΔCP30/ΔG30)、120 min的C肽/血糖(ΔCP120/ΔG120)显著高于基础组,胰岛素抵抗指数(HOMA-IR)及餐后2 h胰岛素(2 hFINS)含量低于基础组,差异有统计学意义(P<0.05)。结论与口服降糖药相比,早期胰岛素强化疗法用于临床老年2型糖尿病治疗中具有更为显著的疗效,胰岛素指标改善效果更佳。