阿卡波糖片联合精蛋白锌重组赖脯胰岛素混合注射液(25R)治疗口服药失效的老年2型糖尿病临床探讨

Clinical Study on the Treatment of the Combination of Acarbose Tablets and Lispro Mix25 Insulin on the Type 2 Diabetes Elder Patients with Inadequate Glycaemic Control by Drugs

关键词:  2型糖尿病  老年人  阿卡波糖片  精蛋白锌重组赖脯胰岛素混合注射液(25R)

Key words:  type 2 diabetes mellitus  the elderly  acarbose tablets  lispro mix25

摘要:

目的 探讨阿卡波糖片联合精蛋白锌重组赖脯胰岛素混合注射液(25R)治疗口服降糖药物血糖控制不佳(失效)的老年2型糖尿病患者的疗效及安全性。方法 选择口服降糖药物血糖控制不佳的老年2型糖尿病患者80例。随机分为治疗组和对照组各40例。治疗组每天餐时口服阿卡波糖片，早、晚餐前即刻皮下注射精蛋白锌重组赖脯胰岛素混合注射液(25R)；对照组每天早、晚餐前30 min皮下注射精蛋白锌重组人胰岛素混合注射液。根据血糖水平，每3 d调整一次胰岛素剂量，以空腹血糖(FPG)<8.0 mmol·L^-1，餐后血糖(2hPG)<10.0 mmol·L^-1为治疗目标，共治疗12周，观察FPG、2hPG、糖化血红蛋白(HbA1c) 水平，胰岛素用量及低血糖反应情况。结果 治疗12周后，2组的全天血糖谱、HbA1c较治疗前显著下降(P<0.01)；治疗组2hPG较对照组显著下降(P<0.05)，治疗组胰岛素用量(28.3±6.40)U·d^-1较对照组显著减少(35.70 ±5.80) U·d^-1(P<0.01)，低血糖反应发生1例(2.5%)明显低于对照组8例(20%)(P<0.05)。结论 阿卡波糖片联合精蛋白锌重组赖脯胰岛素混合注射液(25R)为针对口服降糖药血糖控制不佳的老年2型糖尿病患者的一种较有效、安全的治疗方法。

Abstract:

OBJECTIVE To study the efficacy and safety of acarbose tablets combined with lipson mix25 insulin in treatment of the type 2 diabetes elder patients with inadequate glycaemic control by drugs. METHODS Eighty type 2 diabetes patients with inadequate glycaemic control by drugs were divided into treatment group and control group with 40 cases in each group randomly. In the treatment group, 40 patients were given acarbose tablets during meal and injection of lispro mix25 before breakfast and supper respectively, while 40 patients in the control group were given injection of humulin 70/30 30 minutes before breakfast and supper for 12 weeks. The dose of insulin were adjusted every 3 days according to the level of glucose, reaching the aim of fasting glucose (FPG) less than 8.0 mmol·L^-1 and postprandial (2 hours after meal) glucose (2hPG) less than 10 mmol·L^-1. The FPG, 2hPG, HbA1c, dose of insulin and the incidence of hypoglycemia were observed. RESULTS Compared with before, the daily glucose profile and the level of HbA1c of the 2 groups dropped obviously after 12 weeks treatments (P<0.01). At the end of the experiment, the 2hPG was decreased markedly in treatment group compared with control group (P<0.05), and the dose of insulin was markedly lower in treatment group [(28.3±6.4)U·d^-1]than in control group [(35.7±5.8 U·d^-1) (P<0.01). Only one case of hypoglycemia in treatment group (2.5%) was also lower than 8 cases in control group (20%) (P<0.05). CONCLUSION It’s an effective and safe way to use lispro mix25 insulin combined with acarbose tablets in treatment of the type 2 diabetes elder patients with inadequate glycaemic control by drugs.