人胰岛素类似物联合治疗与胰岛素泵治疗初诊2型糖尿病的对比研究
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[摘要] 目的：观察门冬胰岛素(诺和锐)联合甘精胰岛素(来得时)与用胰岛素泵强化治疗伴明显高血糖的初诊2型糖尿病的疗效及成本。方法：将80例初诊伴明显高血糖的2型糖尿病患者随机分为A、B两组，每组40例。A组三餐前皮下注射诺和锐联合睡前皮下注射来得时；B组利用胰岛素泵加诺和锐持续泵入及分别注射三餐前大剂量。比较两组患者治疗后血糖控制及低血糖发生情况、血糖达标时间、成本及每日胰岛素用量。结果：治疗后两组患者血糖、胰岛素用量、血糖达标时间差异无统计学意义(均P>0.05)，血糖达标时治疗成本B组明显高于A组(P<0.01)。结论：门冬胰岛素联合甘精胰岛素强化治疗与胰岛素泵治疗效果相当，且更经济。
[关键词] 2型糖尿病；门冬胰岛素；甘精胰岛素；胰岛素泵；成本
[中图分类号] R587.1[文献标识码]A [文章编号]1673-7210(2011)03(b)-045-02
Comparison of insulin analogue combination treatment and insulin pump treatment in newly diagnosed type 2 diabetic patients
XIANG Wei, XU Meilun
Department of Endocrinology, the Central People's Hospital of Huizhou City, Huizhou 516001, China
[Abstract] Objective: To observe the effects and the cost of insulin analogue combination treatment and insulin pump treatment in newly diagnosed type 2 diabetic patients with severe hyperglycemia. Methods: 80 newly diagnosed type 2 diabetic patients with severe hyperglycemia were divided into group A and group B in random, with 40 patients in each group. Group A was treated with insulin aspart subcutaneous injections before meals and the insulin glargine subcutaneous injections at bedtime. Group B was treated with continuous subcutaneous insulin infusion and a dose of injection before each meal by insulin pump. The blood glucose, the incidence rate of hypoglycemia, time and cost which spent to make the blood glucose up to the standard, daily insulin doses after treatment were compared. Results: There were no significant difference between two groups in blood glucose, insulin doses, and time when the blood glucose up to the standard after treatment (P>0.05), but the cost of group B was obviously higher than that of group A (P<0.01). Conclusion: Treatment by insulin aspart and insulin glargine combination in newly diagnosed type 2 diabetic patients has the similar effects to insulin pump therapy, but the former is cheaper.
[Key words] Type 2 diabetes; Insulin aspart; Insulin glargine; Insulin pump; Cost
2型糖尿病(T2DM)的发病率正逐年上升，关于严格血糖控制的研究表明，严格的血糖控制是预防糖尿病并发症的最好方法，因此，强化血糖控制的重要性越来越受到重视。同时，英国前瞻性糖尿病研究(UKPDS)提出，初诊未治的T2DM患者平均β细胞功能只剩余50%左右[1]，此结果给T2DM患者尽早使用胰岛素控制好血糖提供了循证学依据 ......
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