Insulin glargine combined with oral hypoglycemic agents versus premixed insulin combined with oral hypoglycemic agents in treating patients with type 2 diabetes mellitus
-
摘要:目的 比较甘精胰岛素与预混胰岛素分别联合口服降糖药治疗2型糖尿病(T2DM)的效果。方法 84例T2DM患者随机分为A组与B组各42例。A组给予甘精胰岛素皮下注射联合口服降糖药阿卡波糖治疗, B组给予预混胰岛素联合阿卡波糖治疗。比较2组治疗前后血糖监测值、胰岛素用量和血糖达标情况。结果 2组治疗后空腹血糖(FBG)、餐后2 h血糖(PBG)、糖化血红蛋白(HbA1c)水平均较本组治疗前显著下降(P < 0.05)。2组治疗后FBG、PBG、HbA1c控制达标率比较，差异均无统计学意义(P>0.05)。A组胰岛素用量少于B组，低血糖发生率低于B组，差异均有统计学意义(P < 0.05)。2组心脑血管事件发生率比较，差异无统计学意义(P>0.05)。结论 甘精胰岛素与预混胰岛素分别联合阿卡波糖均能有效控制血糖，但甘精胰岛素联合阿卡波糖方案能显著减少胰岛素用量，降低低血糖发生率。Abstract:Objective To compare the effect of insulin glargine combined with oral hypoglycemic agents and premixed insulin combined with oral hypoglycemic agents in treating patients with type 2 diabetes mellitus (T2DM).Methods A total of 84 patients with T2DM were randomly divided into group A and group B, with 42 cases in each group. Group A was treated with subcutaneous injection of insulin glargine combined with acarbose, while group B was treated with premixed insulin combined with acarboses. The value of blood glucose monitoring, insulin dosage and blood sugar achievement were compared before and after treatment between two groups.Results After treatment, the levels of fasting blood glucose (FBG), postprandial blood glucose (PBG) and glycosylated hemoglobin (HbA1c) in both groups were significantly lower than those before treatment (P < 0.05). There were no significant differences in the control rate of FBG, PBG and HbA1c between the two groups after treatment (P>0.05). The dosage of insulin in group A was significantly less than that in group B, and the incidence rate of hypoglycemia was significantly lower than that in group B (P < 0.05). There was no significant difference in the incidence rates of cardiovascular and cerebrovascular events between the two groups (P>0.05).Conclusion Both insulin glargine and premixed insulin combined with acarbose can effectively control blood sugar, but insulin glargine combined with acarbose can significantly reduce insulin dosage and the incidence rate of hypoglycemia.
-
Keywords:
- type 2 diabetes mellitus /
- insulin glargine /
- premixed insulin /
- acarbose /
- glycemic control /
- safety
-
-
表 1 2组治疗前后FBG、PBG、HbA1c水平比较(x±s)
组别 n FBG/(mmol/L) PBG/(mmol/L) HbAlc/% 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 A组 42 8.97±1.73 6.61±1.02* 12.83±2.58 8.98±1.47* 8.74±1.16 6.98±1.05* B组 42 8.90±1.80 6.58±0.97* 12.79±2.61 9.03±1.45* 8.76±1.20 7.02±1.12* FBG: 空腹血糖; PBG: 餐后2 h血糖; HbA1c: 糖化血红蛋白。与治疗前比较, *P < 0.05。 
下载: 导出CSV
表 2 2组FBG、PBG和HbA1c控制达标率比较[n(%)]
组别 n FBG PBG HbA1c A组 42 26(61.90) 28(66.67) 25(59.52) B组 42 29(69.05) 30(71.43) 26(61.90) FBG: 空腹血糖; PBG: 餐后2 h血糖; HbA1c: 糖化血红蛋白。
下载: 导出CSV
表 3 2组胰岛素用量和低血糖发生情况比较(x±s)[n(%)]
组别 n 胰岛素用量/(IU/d) 低血糖 心脑血管事件 A组 42 17.52±4.28 2(4.76) 0 B组 42 30.24±5.76* 8(19.05)* 1(2.38) 与A组比较, *P < 0.05。
下载: 导出CSV
-
[1] 荣义华, 谷巍, 耿建林, 等. 不同胰岛素皮下注射方案T2DM患者的血糖变异性比较[J]. 中国现代医学杂志, 2017, 27(17): 103-107. doi: 10.3969/j.issn.1005-8982.2017.17.022 [2] Melladogil J M, Fuentemartín E, Lorenzo P I, et al. The type 2 diabetes-associated HMG20A gene is mandatory for islet beta cell functional maturity[J]. Cell Death & Disease, 2018, 9(3): 279-284. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5833347/
[3] 许洪梅, 穆纯, 包頔, 等. 2型糖尿病患者低血糖恐惧行为现状及影响因素分析[J]. 中华糖尿病杂志, 2018, 10(11): 735-739. doi: 10.3760/cma.j.issn.1674-5809.2018.11.009 [4] 苏杭, 周健, 贾伟平. 2016年ADA糖尿病医学诊疗标准解读[J]. 中国医学前沿杂志, 2018, 10(1): 66-74. https://www.cnki.com.cn/Article/CJFDTOTAL-YXQY201601007.htm [5] 世界卫生组织. 《全球糖尿病报告》[J]. 中国卫生政策研究, 2016, 15(4): 61-63. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWZ201604013.htm [6] 颜穗珺, 李会芳. 中国糖尿病的患病概况[J]. 昆明医科大学学报, 2017, 38(3): 1-5. doi: 10.3969/j.issn.1003-4706.2017.03.001 [7] Kumar S, Jang H C, Demira N G, et al. Efficacy and safety of once-daily insulin degludec/insulin aspart compared with once-daily insulin glargine in participants with Type 2 diabetes: a randomized, treat-to-target study[J]. Diabetic Medicine, 2017, 34(2): 180-188. doi: 10.1111/dme.13125
[8] Pettus J, Roussel R, Zhou F L, et al. Rates of Hypoglycemia Predicted in Patients with Type 2 Diabetes on Insulin Glargine 300 U/ml Versus First-and Second-Generation Basal Insulin Analogs: The Real-World LIGHTNING Study[J]. Diabetes Therapy, 2019, 10(2): 617-633. doi: 10.1007/s13300-019-0568-8
[9] 谢静, 蒲丹岚, 杨刚毅, 等. 长效胰升血糖素样肽1类似物与甘精胰岛素治疗2型糖尿病患者疗效及安全性的Meta分析[J]. 中国糖尿病杂志, 2018, 26(2): 89-95. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGTL201802001.htm [10] Harreiter J, Kosi-Trebotic L, Lukas A, et al. Switch to Combined GLP1 Receptor Agonist Lixisenatide with Basal Insulin Glargine in Poorly Controlled T2DM Patients with Premixed Insulin Therapy: A Clinical Observation and Pilot Study in Nine Patients[J]. Diabetes Therapy, 2017, 8(3): 683-692. doi: 10.1007/s13300-017-0249-4
[11] 王曹锋, 蔡文玮, 陈谊, 等. 阿卡波糖控制不佳的老年2型糖尿病患者联合甘精胰岛素或中效胰岛素对血糖的影响[J]. 老年医学与保健, 2017, 23(2): 105-108. https://www.cnki.com.cn/Article/CJFDTOTAL-LYBJ201702014.htm [12] 简树财, 刘毅, 李明秀, 等. 甘精胰岛素与预混胰岛素联合阿卡波糖治疗2型糖尿病的疗效及安全性评价[J]. 检验医学与临床, 2017, 14(11): 1605-1607. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGTL201405017.htm [13] 魏冬红. 甘精胰岛素联合阿卡波糖治疗老年2型糖尿病疗效观察[J]. 现代中西医结合杂志, 2015, 24(20): 2221-2223. https://www.cnki.com.cn/Article/CJFDTOTAL-JXYY201502024.htm [14] 王永芬. 甘精胰岛素联合阿卡波糖治疗老年糖尿病临床研究[J]. 中国药物与临床, 2019, 19(1): 53-54. https://www.cnki.com.cn/Article/CJFDTOTAL-YWLC201901024.htm [15] 杨松, 谷媛媛, 李兆亮, 等. 沙格列汀或格列美脲联合甘精胰岛素对2型糖尿病患者血糖波动影响的观察[J]. 中国糖尿病杂志, 2015, 23(3): 237-240. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGTL201503015.htm [16] 杨华, 许学忠, 祁平, 等. 甘精胰岛素注射液联合阿卡波糖片治疗继发性磺脲类药物失效的2型糖尿病的临床研究[J]. 中国临床药理学杂志, 2017, 33(3): 219-221. https://www.cnki.com.cn/Article/CJFDTOTAL-GLYZ201703008.htm [17] 芦荣, 苏文博, 刘芳. 皮下注射甘精胰岛素对2型糖尿病并发上消化道出血患者急性期血糖控制的效果分析[J]. 现代消化及介入诊疗, 2018, 23(1): 42-44. https://www.cnki.com.cn/Article/CJFDTOTAL-XDXH201801013.htm
计量
- 文章访问数: 323
- HTML全文浏览量: 155
- PDF下载量: 4
苏公网安备 32100302010246号
