摘要
目的观察精蛋白锌重组赖脯胰岛素混合液25R(优泌乐25)联合阿卡波糖(拜唐苹)治疗老年2型糖尿病的疗效及安全性。方法选择口服降糖药物血糖控制不佳的老年2型糖尿病患者80例,随机分为观察组和对照组,各40例。观察组患者每天早、晚餐前即刻皮下注射优泌乐25,餐时口服拜唐苹150 mg/d;对照组患者每天早、晚餐前30 min皮下注射即精蛋白锌重组人胰岛素混合液70/30(优泌林70/30)。根据血糖水平,每3 d调整1次胰岛素剂量,以空腹血糖(FPG)<8.0 mmol/L、餐后2 h血糖(2 hPG)<10.0 mmol/L为治疗目标,共治疗12周。观察治疗前后两组患者FPG、2 hPG、糖化血红蛋白(HbA1c)水平,胰岛素用量及低血糖反应发生率。结果治疗12周后,观察组患者3餐后2 hPG、HbA1c均较对照组显著下降,差异有统计学意义(P<0.05);观察组患者胰岛素用量为(28.3±6.4)U/d,显著少于对照组的(35.7±5.8)U/d,差异有统计学意义(P<0.01);观察组低血糖反应发生率为2.5%(1/40),显著低于对照组的20.0%(8/20),差异有统计学意义(P<0.05)。结论对于口服降糖药物血糖控制不佳的老年2型糖尿病患者,给予皮下注射优泌乐25联合口服阿卡波糖,能使患者的3餐后血糖、HbA1c控制更理想,所用胰岛素剂量更少,低血糖反应发生率更低,且比较安全。
Objective To observe the efficacy and safety of Mixed Protamine Zinc Recombinant Human Insulin lispro Injection（25R）（Lispro Mix25 insulin） combined with Acarbose Tablets in treating type 2 diabetes mellitus in the elderly.Methods Eighty type 2 diabetes patients with inadequate glycaemic control by drugs were divided into 2 groups randomly： observation group（40 cases treated with Lispro Mix25 and Acarbose Tablets） and control group 〔40 cases treated with Humulin（70/30） Mixed Protamine Zinc Recombinant Human Insulin Injection 70/30〕.In the observation group,40 patients were given Acarbose Tablets during meal and injection of Lispro Mix25 before breakfast and supper respectively,while 40 patients in the control group were given injection of Humulin（70 /30） 30 minutes before breakfast and supper.The dose of insulin were adjusted every 3 days according to the level of glucose,aiming at reducing fasting glucose（FPG） less than 8.0 mmol/L and postprandial（2 hours after meal） glucose（2 hPG） less than 10 mmol/L.The treatment lasted 12 weeks.The FPG,2 hPG,HbA1c,dose of insulin and the incidence of hypoglycemia were observed.Results The level of 2 hPG and HbA1c of observation group dropped significantly compared with control group after 12 weeks treatments（P 0.05）.The dose of insulin was significantly lower in the observation group 〔（28.3 ± 6.4） U/d〕than in the control group 〔（35.7 ± 5.8） U/d,P 0.01〕.The incidence of hypogly-cemia in the observation group（2.5%） was also significantly lower than that in the control group（20.0%）（P 0.05）.Conclusion For the elder type 2 diabetic patients whose blood glucose cannot be controlled by oral antidiabetic drugs,the combination of Lispro Mix25 and Acarbose Tablets has better treatment effects on controlling the daily glucose profile and the level of HbA1c with less dose of insulin and lower incidence of hypoglycemia.So it＇s effective and safe to use Lispro Mix25 insulin combined with Acarbose Tablets in treating type 2 diabetes mellitus in the elderly.
出处
《中国全科医学》
CAS
CSCD
北大核心
2010年第33期3787-3789,共3页
Chinese General Practice
