口服降糖药血糖控制不佳的2型糖尿病加用地特胰岛素或甘精胰岛素的疗效比较

目的评估口服降糖药血糖控制欠佳的2型糖尿病患者联合地特胰岛素或甘精胰岛素治疗的有效性和安全性。方法 90例血糖控制欠佳的2型糖尿病患者随机分为地特胰岛素组和甘精胰岛素组。在16周治疗期调整胰岛素剂量至空腹血糖≤6.0 mmol/L。记录治疗前后空腹血糖（FPG）、糖化血红蛋白（HbA1c）、低血糖事件及体重。结果治疗16周,两组FPG及HbA1c均较基线下降,两组间差异无统计学意义。两组低血糖发生率均为6.6%,但地特胰岛素组的体重增加明显低于甘精胰岛素组（P〈0.05）。结论口服降糖药血糖控制欠佳的2型糖尿病患者联合地特胰岛素或甘精胰岛素均能有效控制血糖,并且有较低的低血糖风险。相比甘精胰岛素,地特胰岛素在减少体重增加方面更有优势。

Comparison of once-daily insulin detemir with insulin glargine added to a regimen of oral antidiabetic drugs in poorly controlled type 2 diabetes

Objective To assess the efficacy and safety of insulin detemir or insulin glargine added to oral drug therapy for type 2 diabetes.Methods 90 patients with type 2 diabetes inadequately controlled were randomized to addition of once-daily insulin detemir（Det group） or insulin glargine（Gla group）for 16 weeks,and insulin doses were titrated toward prebreakfast glucose targets of ≤6.0 mmol/L.Outcomes assessed included fasting blood glucose（FBG）,HbA1c,risk of hypoglycemia,and body weight.Results At the 16th week,both FPG and HbA1c decreased in two groups,but there was no significant difference between the two groups.6.6% patients in both detemir and glargine experienced hypoglycemia.Mean weight gain of Det group was lower than that of Gla group（P0.05）.Conclusion Addition of insulin detemir or insulin glargine to oral drug therapy for type 2 diabetes achieves clinically improvements in glycemic control with low risk of hypoglycemia.Treatment with detemir can achieve extra benefit in reducing weight gain.