中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2014年
2期
171-173
,共3页
杨艳%李蓬秋%包明晶%刘丽梅%张学军%鲜杨%吴冀川%张磊%朱显军
楊豔%李蓬鞦%包明晶%劉麗梅%張學軍%鮮楊%吳冀川%張磊%硃顯軍
양염%리봉추%포명정%류려매%장학군%선양%오기천%장뢰%주현군
2型糖尿病%甘精胰岛素%预混胰岛素
2型糖尿病%甘精胰島素%預混胰島素
2형당뇨병%감정이도소%예혼이도소
Diabetes mellitus type 2%Glargine insulin%Premixed insulin
目的 观察2型糖尿病患者从预混胰岛素转换为甘精胰岛素联合口服降糖药物(OADs)治疗的效果、安全性和患者的满意度.方法 采用自身前后对照研究,选择2型糖尿病患者,接受预混胰岛素治疗至少3个月,联合/或未联合OADs治疗,且糖化血红蛋白(HbA1c)≤10.0％的2型糖尿病患者43例,基于患者和医师的考虑,将预混胰岛素转换为甘精胰岛素联合OADs治疗,由医师根据血糖调整胰岛素和OADs的剂量,随访16周,目标空腹血糖≤5.6 mmol/L.结果 共36例患者完成全部随访观察,治疗16周后空腹血糖、餐后2h血糖、HbA1c均与治疗前相当(P均＞0.05),而胰岛素用量明显减少[(23.8±6.0)、(9.6±4.0) U/d,t=13.59,P＜0.01],体质量指数较治疗前明显下降[(24.4±2.9)、(23.8±2.8)kg/m2,t=3.25,P＜0.05];随访期间36例入组患者中15例患者共发生低血糖30次,低血糖发生率41.7％(15/36),均无需他人帮助,少量进食后缓解,无重度低血糖发生,无患者因低血糖反应而退出本研究;36例患者转换前治疗总体满意率为36.1％ (13/36),转换后为72.2％(26/36),转换后总体满意度明显高于转换前(x2=6.26,P＜O.05).结论 HbA1c≤7.0％时将预混胰岛素转换为甘精胰岛素联合OADs治疗能有效控制血糖,且胰岛素用量及注射次数减少,患者体质量减轻,治疗满意度高.
目的 觀察2型糖尿病患者從預混胰島素轉換為甘精胰島素聯閤口服降糖藥物(OADs)治療的效果、安全性和患者的滿意度.方法 採用自身前後對照研究,選擇2型糖尿病患者,接受預混胰島素治療至少3箇月,聯閤/或未聯閤OADs治療,且糖化血紅蛋白(HbA1c)≤10.0％的2型糖尿病患者43例,基于患者和醫師的攷慮,將預混胰島素轉換為甘精胰島素聯閤OADs治療,由醫師根據血糖調整胰島素和OADs的劑量,隨訪16週,目標空腹血糖≤5.6 mmol/L.結果 共36例患者完成全部隨訪觀察,治療16週後空腹血糖、餐後2h血糖、HbA1c均與治療前相噹(P均＞0.05),而胰島素用量明顯減少[(23.8±6.0)、(9.6±4.0) U/d,t=13.59,P＜0.01],體質量指數較治療前明顯下降[(24.4±2.9)、(23.8±2.8)kg/m2,t=3.25,P＜0.05];隨訪期間36例入組患者中15例患者共髮生低血糖30次,低血糖髮生率41.7％(15/36),均無需他人幫助,少量進食後緩解,無重度低血糖髮生,無患者因低血糖反應而退齣本研究;36例患者轉換前治療總體滿意率為36.1％ (13/36),轉換後為72.2％(26/36),轉換後總體滿意度明顯高于轉換前(x2=6.26,P＜O.05).結論 HbA1c≤7.0％時將預混胰島素轉換為甘精胰島素聯閤OADs治療能有效控製血糖,且胰島素用量及註射次數減少,患者體質量減輕,治療滿意度高.
목적 관찰2형당뇨병환자종예혼이도소전환위감정이도소연합구복강당약물(OADs)치료적효과、안전성화환자적만의도.방법 채용자신전후대조연구,선택2형당뇨병환자,접수예혼이도소치료지소3개월,연합/혹미연합OADs치료,차당화혈홍단백(HbA1c)≤10.0％적2형당뇨병환자43례,기우환자화의사적고필,장예혼이도소전환위감정이도소연합OADs치료,유의사근거혈당조정이도소화OADs적제량,수방16주,목표공복혈당≤5.6 mmol/L.결과 공36례환자완성전부수방관찰,치료16주후공복혈당、찬후2h혈당、HbA1c균여치료전상당(P균＞0.05),이이도소용량명현감소[(23.8±6.0)、(9.6±4.0) U/d,t=13.59,P＜0.01],체질량지수교치료전명현하강[(24.4±2.9)、(23.8±2.8)kg/m2,t=3.25,P＜0.05];수방기간36례입조환자중15례환자공발생저혈당30차,저혈당발생솔41.7％(15/36),균무수타인방조,소량진식후완해,무중도저혈당발생,무환자인저혈당반응이퇴출본연구;36례환자전환전치료총체만의솔위36.1％ (13/36),전환후위72.2％(26/36),전환후총체만의도명현고우전환전(x2=6.26,P＜O.05).결론 HbA1c≤7.0％시장예혼이도소전환위감정이도소연합OADs치료능유효공제혈당,차이도소용량급주사차수감소,환자체질량감경,치료만의도고.
Objective To evaluation the efficacy,safety and treatment satisfaction of glargine plus oral medications(OADs) switching from premixed insulin on patients with type 2 diabetic.Methods Forty-three patients with type 2 diabetes were enrolled into our study.All patients were treated with twice-daily premixed insulin therapy for at least 3 months with or without OADs and their glycosylated haemoglobin(HbA1c) were less than 10.0％.The aim of OADs treatment was FBG ≤ 5.6 mmol/L Results Thirty-six cases were performed a 16 weeks follow-up and no one lost.After 4 months OADs treatment,the levels of fasting blood-glucose(FBG),2 h postprandial blood glucose (PBG),and HbAlc were similar with before OADs treatment (P ＞0.05).However,the dosage of insulin decreased from (23.8 ± 6.0) U/d before treatment to (9.6 ± 4.0) U/d after treatment,and the different was significant (t =13.59,P ＜ 0.01).Body mess index (BMI) also significant decreased from (24.4 ±2.9) kg/m2 to (23.8 ±2.8) kg/m2 (t =3.25,P ＜0.05).During follow-up periods,15 patients were with hypoglycemia for 30 times and the rate of hypoglycemia was 41.7％ (15/36).Hypoglycemia can be recovery without others help,and small amount of feeding after remission.No patient with hypoglycemia withdrawn from the study.The overall satisfaction rate after OADs treatment was 72.2％ (26/36),higher than that before treatment (36.1％ (13/36)),x2 =6.26,P ＜0.05).Conclusion When patients' HbA1c less than 7.0％,the glargine insulin plus OADs treatment switching from premixed insulin can effectively control the level of blood glucose,reduce insulin dosage and times of injection,get less weight gain,and increase treatment satisfaction.
