CAJ | 학술논문

目的比较空腹血糖控制不佳的2型糖尿病患者加用甘精胰岛素(glargine)或中效胰岛素治疗对血糖波动的影响.方法 30例口服抗糖尿病药治疗的2型糖尿病患者(空腹血糖>9.0 mmoL/L,HbA1C> 8.5%),按1:1随机分成两组,分别加用甘精胰岛素(来得时(R))或中效胰岛素(诺和灵(R)N)联合治疗.以空腹指尖毛细血管血糖<6.0 mmol/L为目标,用动态血糖检测仪监测患者血糖水平,计算全天血糖水平的标准差(SDBG)、最大血糖波动幅度(LAGE)以及空腹血糖变异系数(CV-FPG)作为反映lffL糖波动的指数.结果加用甘精胰岛素组上述三个指标均低于加用中效胰岛素组(SDBG:1.49±0.35 vs 1.73±0.46;LAGE:3.23±0.76 vs 3.73±1.00;CV-FPG 17.26±2.24 vs 3520.33±3.21,均P<0.05),同时甘精胰岛素组低血糖发生人次数也低于中效胰岛素组,但差异无统计学意义(P>0.05).结论空腹血糖控制不佳的2型糖尿病患者加用甘精胰岛素比加用中效胰岛素治疗更有利于血糖的平稳,且不增加低血糖的风险.
목적 비교공복혈당공제불가적2형당뇨병환자가용감정이도소(glargine)혹중효이도소치료대혈당파동적영향.방법 30례구복항당뇨병약치료적2형당뇨병환자(공복혈당>9.0 mmoL/L,HbA1C> 8.5%),안1:1수궤분성량조,분별가용감정이도소(래득시(R))혹중효이도소(낙화령(R)N)연합치료.이공복지첨모세혈관혈당<6.0 mmol/L위목표,용동태혈당검측의감측환자혈당수평,계산전천혈당수평적표준차(SDBG)、최대혈당파동폭도(LAGE)이급공복혈당변이계수(CV-FPG)작위반영lffL당파동적지수.결과 가용감정이도소조상술삼개지표균저우가용중효이도소조(SDBG:1.49±0.35 vs 1.73±0.46;LAGE:3.23±0.76 vs 3.73±1.00;CV-FPG 17.26±2.24 vs 3520.33±3.21,균P<0.05),동시감정이도소조저혈당발생인차수야저우중효이도소조,단차이무통계학의의(P>0.05).결론 공복혈당공제불가적2형당뇨병환자가용감정이도소비가용중효이도소치료경유리우혈당적평은,차불증가저혈당적풍험.
Objective To compare the excursion of blood glucose (BG) in the type 2 diabetes mellitus treated with oral antidiabetic drugs (OADs) plus glargine or human isophane insulin (HII). Methods A 1 : 1 randomization schedule assigned 30 type 2 diabetics inadequately controlled on OADs (fasting BG>9.0 mmol/L and HbA1C > 8.5%) to 2 groups additionally treated with glargine or HII. The insulin dose was titrated to achieve fasting capillary BG<6.0 mmol/L. Montoring BG with continuous glucose monitoring system, then the standard deviation of BG (SDBG), maximal excursion of BG (LAGE) and coefficient of variation (CV) of fasting plasma glucose (FPG) were calculated. Results SDBG (1.49±0.35 vs 1.73±0.46), LAGE (3.23±0.76 vs 3.73± 1.00) and CV-FPG (17.26±2.24 vs 20.33±3.21) were lower in glargine group than those in HII group (P< 0.05). No difference could be found in hypoglycaemia between two groups. Conclusion OADs plus glargine could make blood glucose more stable than OADs plus HII without increasing the incidence of hypoglycaemia.