来得时联合诺和锐治疗2型糖尿病疗效观察(1)
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[摘要] 目的：探讨来得时(甘精胰岛素)联合诺和锐(门冬胰岛素)治疗T2DM患者的疗效及安全性。方法：将40例口服降糖药疗效差的2型糖尿病患者随机分为两组，每组20例，来得时组采用三餐时注射诺和锐，每晚九点注射来得时；诺和灵组采用三餐前30 min皮下注射诺和灵R，每晚十点注射诺和灵N，3个月后观察记录各项指标的变化情况。结果：两组治疗后，FBG、2 hPG、HbA1c均显著下降(P<0.05)，FC-P、2 hC-P均显著升高(P<0.05)；来得时组血糖达标时间明显缩短(P<0.01)。两组均未发生严重低血糖事件，来得时组发生低血糖次数、夜间低血糖次数均显著减少(P<0.01)。结论：来得时联合诺和锐治疗2型糖尿病更具有效性和安全性。
[关键词] 来得时；诺和锐；2型血糖病(T2DM)；疗效；安全性
[中图分类号] R587.1[文献标识码]B [文章编号]1673-7210(2010)11(b)-065-02
The therapeutic effect of Lantus combined with Novorapid on type 2 diabetes
BAI Huiqin, ZHANG Zijun
(Department of Endocrinology, the Head Hospital of Yangquan Coal Industry Group, Shanxi Province, Yangquan 045000, China)
[Abstract] Objective: To discuss the therapeutic effect and safety of Lantus combined with Novorapid in the treatment of patients with type 2 diabetes. Methods: 40 cases of type 2 diabetes were randomly divided into group A and group B, each group with 20 cases. Novorapid before each meal and bedtime Lantus (group A) versus novolin R before each meal and bedtime novolin N (group B) on patients with type 2 diabetes. After the three months treatment, glucose-targeted time (GTT), FBG, 2 hPG, glucose drift and hypoglycemic frequency were compared. Results: Group A and group B had dropped on FBG, 2 hPG and HbA1c (P<0.05), and had risen on FC-P and 2 hC-P (P<0.05). But group A showed more rapid and stable effect in lowering blood sugar than group B (P<0.01), and GTT was shorter. Conclusion: For type 2 diabetes patients, Lantus and Novorapid have better therapeutic effects and lower hypoglycemic frequency.
[Key words] Lantus; Novorapid; Type 2 diabetes; The therapeutic; Safety
2007年《中国2型糖尿病防治指南》强调早期联合治疗、尽早达标和个体化治疗，同时提出应及时启用基础胰岛素。理想的胰岛素治疗应该是符合生理性胰岛素分泌的治疗[1]。本研究分别用来得时(甘精胰岛素)联合诺和锐(门冬胰岛素)与诺和灵N联合诺和灵R对口服降糖药血糖控制不理想的T2DM患者40例进行为期3个月的观察，探讨更为有效和安全的胰岛素联合治疗方案。
1 对象与方法
1.1 对象
选择2010年2～8月在我院内分泌门诊及住院的40例2型糖尿病患者。男23例，女17例；年龄26～60岁，平均43岁。空腹血糖(FBG)(12.83±3.68) mmol/L，餐后2 h血糖(2 hPG)(18.50±5.10) mmol/L，糖化血红蛋白(HbA1c)>8.5%，体重指数(BMI)20.7～32.1 kg/m2。纳入标准：①诊断上符合1999年世卫生组织(WHO)制定的2型糖尿病诊断标准；②病程小于5年的2型糖尿病 ......
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