谷赖胰岛素联合甘精胰岛素治疗老年2型糖尿病的临床研究
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摘要
目的探讨谷赖胰岛素联合甘精胰岛素与赖脯胰岛素联合甘精胰岛素治疗老年2型糖尿病的疗效与安全性。方法选取2017年4月至2017年10月于大连市友谊医院内分泌科住院及门诊治疗的老年2型糖尿病患者64例。入选患者随机分为两组,实验组予以谷赖胰岛素联合甘精胰岛素降糖治疗,对照组行赖脯胰岛素联合甘精胰岛素降糖治疗,比较两组在治疗前后血糖变化、日需胰岛素剂量及低血糖发生率。结果①在治疗12周后,实验组和对照组患者的空腹、餐前、三餐后2 h、睡前血糖及糖化血红蛋白均有显著下降(P<0.05);②实验组的餐后2 h血糖控制优于对照组(P<0.05);③两组在糖化血红蛋白控制上差异无统计学意义;④实验组在控制血糖达标所需日胰岛素剂量低于对照组(P<0.05);⑤治疗l2周期间,谷赖胰岛素组和赖脯胰岛素组低血糖事件发生率分别为6.3%(2/32)和9.4%(3/32),差异无统计学意义。结论与赖脯联合甘精相比,谷赖胰岛素联合甘精胰岛素能更好控制老年2型糖尿病的血糖,且胰岛素用量少、耐受好。
引文
[1]陈玉环,文轶,林丽莉.甘精胰岛素在初诊老年2型糖尿病患者治疗中的应用价值[J].实用心脑肺血管病杂志,2014,18(11):110-111.
[2] International Diabetes Federation. IDF diabetes at-las 7th edition[R/OL].2016.
[3]朱大龙,张红.谷赖胰岛素:一种新型速效人胰岛素类似物[J].新药介绍,2012,9(22):47-49.
[4] Dreyer M, Prager R, Robinsn A, et a1. Efficacy andsafety of insulin glulisine in patients with type 1diabetes[J]. Horm Metab Res, 2005,37:702-707.
[5] Kawamori R, Kadowaki T, Ishii H, et a1. Efficacyand safety of insulin glulisine in Japanese pa-tients with type 1 diabetes mellitus[J]. DiabetesObes Metab, 2009,11:89l-899.
[6] Burger F, Scholtz H, Frick A, et a1. Pharmacodynam-ics and pharmacokinetics of insulin glulisine ver-sus insulin lispro and regular human insulin in pa-tients with type 1 diabetes[J]. Diabetes, 2004, 53(Suppl2):A557.
[7] Chao M, Wang W, Zhang Y, et a1. Bioequiva1ence be-tween two human insulin analogs in Chinesepopulation:Glulisine and Lispro[J]. Endocrine,2010,38(1):48-52.
[8] Umpierrez GE, Smiley D, Jacobs S, et a1. Random-ized study of basal—bolus insulin therapy inthe inpatient management of patients with type2 diabetes undergoing general surgery(RABBIT 2surgery)[J]. Diabetes Care, 2011,34(2):256-261.
[9] Ratner R, Wynne A, Nakhle S, et a1. Influenceof preprandial vs. postprandial insulin gluli-sine on weight and glycaemic control in pa-tients initiating basal—bolus regimen fortype 2 diabetes:a multicenter,randomized, parallel,open—label study(NCT0015096)[J]. Diabetes ObesMetab, 2011,13(12):1142-1148.
[2] International Diabetes Federation. IDF diabetes at-las 7th edition[R/OL].2016.
[3]朱大龙,张红.谷赖胰岛素:一种新型速效人胰岛素类似物[J].新药介绍,2012,9(22):47-49.
[4] Dreyer M, Prager R, Robinsn A, et a1. Efficacy andsafety of insulin glulisine in patients with type 1diabetes[J]. Horm Metab Res, 2005,37:702-707.
[5] Kawamori R, Kadowaki T, Ishii H, et a1. Efficacyand safety of insulin glulisine in Japanese pa-tients with type 1 diabetes mellitus[J]. DiabetesObes Metab, 2009,11:89l-899.
[6] Burger F, Scholtz H, Frick A, et a1. Pharmacodynam-ics and pharmacokinetics of insulin glulisine ver-sus insulin lispro and regular human insulin in pa-tients with type 1 diabetes[J]. Diabetes, 2004, 53(Suppl2):A557.
[7] Chao M, Wang W, Zhang Y, et a1. Bioequiva1ence be-tween two human insulin analogs in Chinesepopulation:Glulisine and Lispro[J]. Endocrine,2010,38(1):48-52.
[8] Umpierrez GE, Smiley D, Jacobs S, et a1. Random-ized study of basal—bolus insulin therapy inthe inpatient management of patients with type2 diabetes undergoing general surgery(RABBIT 2surgery)[J]. Diabetes Care, 2011,34(2):256-261.
[9] Ratner R, Wynne A, Nakhle S, et a1. Influenceof preprandial vs. postprandial insulin gluli-sine on weight and glycaemic control in pa-tients initiating basal—bolus regimen fortype 2 diabetes:a multicenter,randomized, parallel,open—label study(NCT0015096)[J]. Diabetes ObesMetab, 2011,13(12):1142-1148.