中华糖尿病杂志
中華糖尿病雜誌
중화당뇨병잡지
CHINES JOURNAL OF DLABETES MELLITUS
2014年
11期
813-816
,共4页
李春君%于德民%李静%于珮%吕春凤%于倩%冯美俊
李春君%于德民%李靜%于珮%呂春鳳%于倩%馮美俊
리춘군%우덕민%리정%우패%려춘봉%우천%풍미준
糖尿病,2型%老年人%基础胰岛素%口服降糖药物
糖尿病,2型%老年人%基礎胰島素%口服降糖藥物
당뇨병,2형%노년인%기출이도소%구복강당약물
Diabetes mellitus,type 2%Elderly%Basal insulin%Oral antidiabetic agents
目的 比较口服降糖药(OADs)血糖控制不佳的老年2型糖尿病患者加用基础胰岛素治疗与增加降糖药物治疗的疗效和安全性.方法 回顾性分析2004年1月至2011年12月于天津医科大学代谢病医院门诊就诊、血糖控制不佳的老年2型糖尿病患者746例,平均年龄69岁,糖化血红蛋白(HbA1c)7.5％ ～ 11.0％,空腹血糖(FBG)＞7.5 mmol/L,分为启动基础胰岛素治疗或增加OADs 2组,观察24周,比较2组血糖、OADs、体重变化和低血糖事件的发生率.组内治疗前后的比较用配对t检验;组间比较采用x2检验.结果 286例患者纳入最终分析,启动基础胰岛素治疗组(A组,n=176例),增加OADs组(B组,n=110例),A组FBG和HbA1c下降幅度明显大于B组(2.5 mmol/L比2.1 mmol/L,2.0％比1.7％,t=-5.86、-3.93,均P＜0.01);A组HbA1c达标率明显高于B组[78.4％(138/176)比54.5％(60/110),x2=18.1,P＜0.01],A组低血糖发生率明显低于B组[31.8％ (56/176)比51.8％(57/110),x2=12.0,P＜0.01],2组体重变化差异无统计学意义.B组OADs剂量和种类明显高于A组.结论 OADs血糖控制不佳的老年2型糖尿病患者尽早启动基础胰岛素治疗是控制血糖安全有效的治疗方案.
目的 比較口服降糖藥(OADs)血糖控製不佳的老年2型糖尿病患者加用基礎胰島素治療與增加降糖藥物治療的療效和安全性.方法 迴顧性分析2004年1月至2011年12月于天津醫科大學代謝病醫院門診就診、血糖控製不佳的老年2型糖尿病患者746例,平均年齡69歲,糖化血紅蛋白(HbA1c)7.5％ ～ 11.0％,空腹血糖(FBG)＞7.5 mmol/L,分為啟動基礎胰島素治療或增加OADs 2組,觀察24週,比較2組血糖、OADs、體重變化和低血糖事件的髮生率.組內治療前後的比較用配對t檢驗;組間比較採用x2檢驗.結果 286例患者納入最終分析,啟動基礎胰島素治療組(A組,n=176例),增加OADs組(B組,n=110例),A組FBG和HbA1c下降幅度明顯大于B組(2.5 mmol/L比2.1 mmol/L,2.0％比1.7％,t=-5.86、-3.93,均P＜0.01);A組HbA1c達標率明顯高于B組[78.4％(138/176)比54.5％(60/110),x2=18.1,P＜0.01],A組低血糖髮生率明顯低于B組[31.8％ (56/176)比51.8％(57/110),x2=12.0,P＜0.01],2組體重變化差異無統計學意義.B組OADs劑量和種類明顯高于A組.結論 OADs血糖控製不佳的老年2型糖尿病患者儘早啟動基礎胰島素治療是控製血糖安全有效的治療方案.
목적 비교구복강당약(OADs)혈당공제불가적노년2형당뇨병환자가용기출이도소치료여증가강당약물치료적료효화안전성.방법 회고성분석2004년1월지2011년12월우천진의과대학대사병의원문진취진、혈당공제불가적노년2형당뇨병환자746례,평균년령69세,당화혈홍단백(HbA1c)7.5％ ～ 11.0％,공복혈당(FBG)＞7.5 mmol/L,분위계동기출이도소치료혹증가OADs 2조,관찰24주,비교2조혈당、OADs、체중변화화저혈당사건적발생솔.조내치료전후적비교용배대t검험;조간비교채용x2검험.결과 286례환자납입최종분석,계동기출이도소치료조(A조,n=176례),증가OADs조(B조,n=110례),A조FBG화HbA1c하강폭도명현대우B조(2.5 mmol/L비2.1 mmol/L,2.0％비1.7％,t=-5.86、-3.93,균P＜0.01);A조HbA1c체표솔명현고우B조[78.4％(138/176)비54.5％(60/110),x2=18.1,P＜0.01],A조저혈당발생솔명현저우B조[31.8％ (56/176)비51.8％(57/110),x2=12.0,P＜0.01],2조체중변화차이무통계학의의.B조OADs제량화충류명현고우A조.결론 OADs혈당공제불가적노년2형당뇨병환자진조계동기출이도소치료시공제혈당안전유효적치료방안.
Objective To assess the efficacy and safety of adding basal insulin to current oral antidiabetic drugs (OADs)regime in poorly controlled elderly patients with type 2 diabetes compared to increasing the OADs.Methods In this retrospective study,we observed 746 elderly outpatients (mean age 69 yrs,glycated hemoglobin A1c(HbA1c) 7.5％-11.0％ and fasting blood glucose(FBG)＞7.5 mmol/L)who were inadequately controlled with OADs for enrollment from our hospital specialist clinics from January 2004 to December 2011.All enrolled patients were divided into 2 groups according to either adding basal insulin to current therapy or increasing OADs.The changes of glucose control,OADs therapy,body weight and the incidence of hypoglycemic events were assessed and compared between the 2 groups during the 24-week observation period.Results A total of 286 patients were included in the final analysis,176 in the adding basal insulin group(Group A)and 110 in the increasing OADs group(Group B).During the 24-week observation period,the reduction of HbA1c and FBG in the Group A were significantly larger than that in the Group B(2.5 mmol/L vs 2.1 mmol/L,2.0％ vs 1.7％,t=-5.86,-3.93,both P＜0.01).HbA1c level＜7.0％ was achieved by 78.4％ patients(138/176)and 54.5％ patients(60/110)in the groups A and B,respectively(x2=18.1,P＜0.01).The group A had fewer total hypoglycemic events compared with group B (31.5％ (56/176)vs 52％ (57/110),x2=12.0,P＜0.01).The patients in the group A had lower doses and number of oral antidiabetic drugs compared with the group B.There was no difference regarding weight gain between the 2 groups.Conclusions The addition of basal insulin to current OADs therapy may be an effective and safe option for poorly controlled elderly patients with type 2 diabetes.
