CAJ | 학술논문

目的：观察睡前注射一次中效胰岛素治疗2型糖尿病的效果,监测低血糖的风险及不良反应的发生情况,了解此治疗方案的疗效及安全性。方法选择本社区42例口服降糖药物而血糖控制不达标的2型糖尿病患者,在口服降糖药的基础上,按自愿的原则分为两组,中效胰岛素(NPH)组(18例)：原有的口服药物不变,睡前加用中效胰岛素皮下注射治疗；口服药物组(24例)：采用增加口服药物剂量方法,逐步增加降糖药物的剂量,达到最大范围。以两组空腹血糖(FBG)均达到≤7.0 mmol/L为目标,共治疗6个月,观察两组血糖控制情况、低血糖事件及其他药物不良反应的发生情况。结果治疗后两组全天血糖谱及糖化血红蛋白(HbA1c)均较基线水平有所下降,但NPH组下降比口服药物组更显著,两组下降幅度比较,差异具有统计学意义(P<0.05)。低血糖方面,两组各发生1例仅有症状的低血糖事件。不良反应方面,药物治疗组胃肠道反应较NPH组明显增高,差异具有统计学意义(8/24,0/18, P<0.01)。结论睡前注射一次中效胰岛素联合口服降糖药物方案治疗血糖控制不理想的2型糖尿病患者,疗效好,容易被患者接受,值得在社区推广。
목적：관찰수전주사일차중효이도소치료2형당뇨병적효과,감측저혈당적풍험급불량반응적발생정황,료해차치료방안적료효급안전성。방법선택본사구42례구복강당약물이혈당공제불체표적2형당뇨병환자,재구복강당약적기출상,안자원적원칙분위량조,중효이도소(NPH)조(18례)：원유적구복약물불변,수전가용중효이도소피하주사치료；구복약물조(24례)：채용증가구복약물제량방법,축보증가강당약물적제량,체도최대범위。이량조공복혈당(FBG)균체도≤7.0 mmol/L위목표,공치료6개월,관찰량조혈당공제정황、저혈당사건급기타약물불량반응적발생정황。결과치료후량조전천혈당보급당화혈홍단백(HbA1c)균교기선수평유소하강,단NPH조하강비구복약물조경현저,량조하강폭도비교,차이구유통계학의의(P<0.05)。저혈당방면,량조각발생1례부유증상적저혈당사건。불량반응방면,약물치료조위장도반응교NPH조명현증고,차이구유통계학의의(8/24,0/18, P<0.01)。결론수전주사일차중효이도소연합구복강당약물방안치료혈당공제불이상적2형당뇨병환자,료효호,용역피환자접수,치득재사구추엄。
Objective To observe the effect of isophane insulin injection before sleep in the treatment of type 2 diabetes mellitus, to monitoring risk of hypoglycemia and incidence of adverse reactions, and to understand the curative effect and safety of this treatment regimen.Methods There were 42 type 2 diabetes mellitus patients with substandard blood glucose level by oral antidiabetic drugs. They were voluntarily divided into two groups. Isophane insulin (NPH) group (18 cases) received subcutaneous injection of isophane insulin before sleep in addition to oral administration. Oral administration group (24 cases) received increased dose of oral administration by gradual increase to maximum range. Treatment lasted for 6 months, aiming at fasting blood glucose (FBG) ≤7.0 mmol/L in both groups. Blood glucose control, hypoglycemia events, and other adverse reactions were observed in the two groups. Results After treatment, both groups had decreased blood glucose profile and glycosylated hemoglobin (HbA1c) level than the baseline level, and NPH group had much obvious decreased level than oral administration group. The difference of decreased level between the two groups had statistical significance (P<0.05). Each group had 1 case of hypoglycemia event with symptoms. Oral administration group had higher gastrointestinal reactions as adverse reactions than NPH group, and their difference had statistical significance (8/24, 0/18, P<0.01).Conclusion Isophane insulin injection before sleep combined with oral administration of antidiabetic drugs can provide good effect in controlling 2 diabetes mellitus patients with unsatisfactory blood glucose control. This method can be easily acceptable for patients, and it is worth promotion in community.