CAJ | 학술논문

　　目的探讨来得时联合拜唐苹和诺和锐30治疗高龄（80岁以上）2型糖尿病（T2DM）患者血糖、糖化血红蛋白（HbA1c）变化，低血糖事件发生率及临床意义。方法将120例口服降糖药物疗效较差的高龄T2DM患者随机分为来得时联合拜唐苹组和诺和锐30组（每组60例）。来得时联合拜唐苹组每日早餐前注射1次来得时加三餐中口服拜唐苹，诺和锐30组早晚餐前各皮下注射1次，共16周，比较两组患者空腹血糖（FBG）及餐后2小时血糖（2hPBG）、甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C），高密度脂蛋白胆固醇（HDL-C）、HbA1c的下降情况，低血糖事件发生率。结果两组治疗前后血糖、TG、TC、LDL-C、HbA1c下降明显，其中来得时联合拜唐苹组HbA1c从（8.8%±2.0%）下降至（7.1%±1.2%）；诺和锐30组HbA1c从（8.9%±2.4%）下降到（7.0%±1.2%）；治疗后两组之间差异无统计学意义（P＞0.05）；来得时联合拜唐苹组低血糖事件发生率明显低于诺和锐30组（3.3%vs 13.3%，P＜0.01）。结论来得时联合拜唐苹组和诺和锐30组都具有明显降低FBG、2hPBG、TG、TC、LDL-C、HbA1c的作用，来得时联合拜唐苹组低血糖事件发生率明显低于诺和锐30组。
　　목적탐토래득시연합배당평화낙화예30치료고령（80세이상）2형당뇨병（T2DM）환자혈당、당화혈홍단백（HbA1c）변화，저혈당사건발생솔급림상의의。방법장120례구복강당약물료효교차적고령T2DM환자수궤분위래득시연합배당평조화낙화예30조（매조60례）。래득시연합배당평조매일조찬전주사1차래득시가삼찬중구복배당평，낙화예30조조만찬전각피하주사1차，공16주，비교량조환자공복혈당（FBG）급찬후2소시혈당（2hPBG）、감유삼지（TG）、총담고순（TC）、저밀도지단백담고순（LDL-C），고밀도지단백담고순（HDL-C）、HbA1c적하강정황，저혈당사건발생솔。결과량조치료전후혈당、TG、TC、LDL-C、HbA1c하강명현，기중래득시연합배당평조HbA1c종（8.8%±2.0%）하강지（7.1%±1.2%）；낙화예30조HbA1c종（8.9%±2.4%）하강도（7.0%±1.2%）；치료후량조지간차이무통계학의의（P＞0.05）；래득시연합배당평조저혈당사건발생솔명현저우낙화예30조（3.3%vs 13.3%，P＜0.01）。결론래득시연합배당평조화낙화예30조도구유명현강저FBG、2hPBG、TG、TC、LDL-C、HbA1c적작용，래득시연합배당평조저혈당사건발생솔명현저우낙화예30조。
Objective To investigate the changes of blood glucose, HbA1c, and incidence of hypoglycemia in the very old patients (over 80 years) with type 2 diabetes mellitus (T2DM) after the treatment of lantus with glucobay or Novomix 30, and the clinical significance. Methods A total of 120 very old T2DM patients poorly controlled with oral hypoglycemic drugs admitted in our department from July 2011 to June 2012 were subjected in this study. They were randomly divided into lantus with glucobay group and Novomix 30 group (n=60 in each group). Lantus was injected before breakfast, and glucobay was taken with meals, while Novomix 30 was injected before morning and evening meals for total 16 weeks. Fasting blood glucose (FBG) and 2-hour postprandial blood glucose (2hPBG), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), the decrease of HbA1c, and the incidence of hypoglycemia were compared between the two groups. Results After the treatment, blood glucose, TG, TC, LDL-C and HbA1c were decreased in the two groups though without significant difference (P>0.05). HbA1c was decreased from (8.8%±2.0%) to (7.1%±1.2%) in the glucobay group, and from (8.9%±2.4%) to (7.0%±1.2%) in Novomix 30 group, with no significant difference between them (P>0.05). The incidence of hypoglycemia was significantly lower in glucobay group than in Novomix 30 group (3.3%vs 13.3%, P<0.01). Conclusion Lantus combined with glucobay and Novomix 30 have the similar improvement in FBG, 2hPBG, TG, TC, LDL-C and HbA1c. But the combination with glucobay has significantly lower incidence of hypoglycemia.