CAJ | 학술논문

目评价甘精胰岛素联合口服降糖药物(OADs)治疗方案对使用预混胰岛素血糖控制欠佳的2型糖尿病患者的疗效及安全性.方法预混胰岛素30/70单独或联合使用OADs血糖控制不良的2型糖尿病患者50例,随机分为治疗组(停用预混胰岛素,改为皮下注射甘精胰岛素联合OADs,n=30)和对照组(继续使用预混胰岛素早、晚餐前皮下注射联合OADs,n=20),各组均依据血糖监测水平调整胰岛素及OADs用量.12周后对比两组患者空腹血糖(FBG)、3餐后2h血糖(2hPG)、糖化血红蛋白A1c(HbA1c)、体重指数(BMI)及试验期间低血糖发生次数.结果与治疗前相比,治疗组及对照组治疗后HbA1c、FBG、3餐2 hPG均有所下降(P均＜0.01)；治疗组及对照组BMI均无明显变化(P＞0.05).与对照组相比,治疗组治疗后FBG、午餐2hPG、BMI及HbA1c均降低(P均＜0.01)；试验期间治疗组低血糖发生次数低于对照组(P＜0.01).结论接受预混胰岛素治疗血糖控制欠佳的2型糖尿病患者,改为甘精胰岛素联合OADs治疗,可显著改善FBG和HbA1c,且不增加体重,简便易行,大大降低了低血糖风险.
목평개감정이도소연합구복강당약물(OADs)치료방안대사용예혼이도소혈당공제흠가적2형당뇨병환자적료효급안전성.방법 예혼이도소30/70단독혹연합사용OADs혈당공제불량적2형당뇨병환자50례,수궤분위치료조(정용예혼이도소,개위피하주사감정이도소연합OADs,n=30)화대조조(계속사용예혼이도소조、만찬전피하주사연합OADs,n=20),각조균의거혈당감측수평조정이도소급OADs용량.12주후대비량조환자공복혈당(FBG)、3찬후2h혈당(2hPG)、당화혈홍단백A1c(HbA1c)、체중지수(BMI)급시험기간저혈당발생차수.결과 여치료전상비,치료조급대조조치료후HbA1c、FBG、3찬2 hPG균유소하강(P균＜0.01)；치료조급대조조BMI균무명현변화(P＞0.05).여대조조상비,치료조치료후FBG、오찬2hPG、BMI급HbA1c균강저(P균＜0.01)；시험기간치료조저혈당발생차수저우대조조(P＜0.01).결론 접수예혼이도소치료혈당공제흠가적2형당뇨병환자,개위감정이도소연합OADs치료,가현저개선FBG화HbA1c,차불증가체중,간편역행,대대강저료저혈당풍험.
Objective To evaluate the efficacy and safety of the treatment of insulin glargine combined with oral hypoglycemic drugs (OADs) for type 2 diabetic patients with poor glycemic control using premixed insulin therapy.Methods Fifty cases of poor blood glucose control patients with type 2 diabetes using 30/70 premixed insulin alone or in combination with OADs were randomly divided into treatment group ( converting premixed insulin into insulin glargine plus OADs,n =30) and control group ( continue to use the premixed insulin plus OADs,n =20).All groups were adjusted the dosage of insulin and OADs based on the levels of blood glucose.After 12 weeks,monitoring and comparing fasting blood glucose(FBG),2 hour postprandial blood glucose(2 h PG),glycosylated hemoglobin A1c(HbA1c) levels,body mass index(BMI) and the incidence of hypoglycemia during the test of the two groups.Results Compared with those before treatment,HbA 1 c,FBG,2 h PG of both groups have declined ( all P ＜ 0.01 ).The treatment group and control group have no significant change in BMI (P ＞ 0.05 ).Compared with the control group,FBG,lunch 2 h PG,BMI and HbAlc of the treatment group is lower ( all P ＜0.01 ).The incidence of hypoglycemia during the test of the treatment group is lower( P ＜ 0.01 ).Conclusions The treatment of insulin glargine combined with OADs for poor glycemic control in type 2 diabetic patients using premixed insulin,can significantly improve the levels of FBG and HbA 1 c,do not increase body weight,and it is simple to use,therefore can significantly reduce the risk of hypoglycemia.