甘精胰岛素联合阿卡波糖对老年2型糖尿病患者血糖及β细胞功能的影响(1)
 |
| 第1页 |
参见附件(1614KB，2页)。
【摘要】 目的 观察甘精胰岛素(IG)联合阿卡波糖治疗老年2型糖尿病(T2DM)的降糖效果及对β细胞功能的影响。方法 将90例口服药联合治疗空腹血糖(FPG)控制不佳的老年T2DM患者,随机分为甘精胰岛素(IG)联合阿卡波糖组和中性鱼精蛋白锌胰岛素(NPH)组。治疗12周后比较两组治疗前后FPG、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、空腹C肽及餐后2 h C肽水平。并对两组低血糖发生率进行比较。结果 治疗12周后两组FPG、2 h PG、HbA1c均下降,IG联合阿卡波糖组低血糖发生较NPH组少,治疗后C肽升高显著,与NPH组比较差异有统计学意义(P<0.05)。结论 甘精胰岛素联合阿卡波糖能较好地控制老年2型糖尿病患者血糖及糖化血红蛋白,且低血糖发生率较低,与NPH比较,安全性更高。
【关键词】2型糖尿病;甘精胰岛素;胰岛β细胞功能
Effectiveness of Acarbose combined with Glargine in blood glucose and function of Beta Cell in eldly Type 2 Diabetes Mellitus
【Abstract】 Objective To investigate the effect of insulin glargine(IG)Eon plasma glucose,beta cell functionin eldly type 2 diabetes mellitus(T2DM)patients.Methods Ninety eldly patients with poor fasting plasma glucose(FPG) control on oral antidiabetic agents with T2DM were randomly divided into two groups:IG combined with Acarbose group,suppliedwith Acarbose before meals and glargine at bedtime,NPH group were supplied NPH before meals and NPH at bedtime.The changes of some clinical indexes[FPG,2 h postprandial blood glucose(2 hPG),HbA1c,C-peptide]in each group were observed before and after treatment.The ratio of hypoglycaemia was compared between two groups.Results The levels of FPG,2 hPG,HbA1c were significantly decreased after treatment in both groups(P<0.05).In the IG combined with Acarbose group,there was a lower accuracy of hypoglycaemia and a significant increase of C peptide after treatment compared with NPH group,with significant differences(P<0.05).Conclusion It is more effective and safer for eldly diabetic patients to use IG combined with Acarbose to decrease BG.Arcabose combined with IG can control high plasma glucose well on elder patients with T2DM and the incidence of hypoglycemia is low.
【Key words】Type 2 diabetes mellitus; Glargine; Beta cell function
2型糖尿病(T2DM)是一种慢性疾病,其治疗目标是有效地控制血糖水平,保护胰岛β细胞功能,减少β细胞凋亡,同时防治血管并发症。随着世界老龄化步伐的加速,我国老年糖尿病患者人数不断攀升。甘精胰岛素(Glargine,IG)为长效胰岛素类似物[1],对β细胞有保护作用,能预防和延缓老年糖尿病患者并发症的发生和发展,减少低血糖事件的发生,使血糖安全达标。本文观察IG联合阿卡波糖治疗老年T2DM的疗效、安全性及对β细胞功能的影响,并与使用预混人胰岛素(NPH)进行对比,为临床日益增多的老年T2DM患者提供更理想的治疗方案,现报告如下。
1 资料与方法
1.1 临床资料 90例患者为2008年6月至2009年10月在本院住院治疗空腹血糖(FPG)控制不佳的老年T2DM患者。符合WHO1999年2型糖尿病诊断标准。年龄≥60岁。其中男43例,女47例。年龄(69.3±2.1)岁。糖尿病病史4~17年,平均(8.3±3.7)年。所有患者既往未使用胰岛素,使用口服降糖药>3个月而血糖控制欠佳,FPG均>13.9 mmol/L。排除标准:①糖尿病酮症酸中毒;②有心衰或不稳定型心绞痛,和/或近1年内发生过心肌梗死;③继发糖尿病;④严重肝肾功能不全者;⑤妊娠、哺乳妇女;⑥合并泌尿系、呼吸道等中度及以上感染;⑦有高血压及心脑肾并发症者 ......
您现在查看是摘要介绍页，详见PDF附件(1614KB，2页)。