地特胰岛素联合阿卡波糖治疗2型糖尿病临床观察

目的 观察地特胰岛素联合阿卡波糖治疗2型糖尿病的临床疗效.方法 对32例经预混精蛋白生物合成人胰岛素治疗血糖控制不佳的2型糖尿病患者,采用地特胰岛素每天1次注射,联合阿卡波糖,每天3次口服,治疗12周,采用自身对照,观察治疗前后三餐前、三餐后、睡前血糖、糖化血红蛋白(HbA1c)水平、体质量指数(BMI)变化及低血糖发生情况、患者治疗依从性和满意率.结果 治疗后三餐前、三餐后及睡前血糖、HbA1c均比治疗前明显下降(t=11.212、14.997、10.863、17.950、11.108、14.034、12.422、22.764,均P＜0.01),日间低血糖发生率3.1％,无夜间症状性低血糖发生,BMI有所下降,但差异均无统计学意义(均P＞0.05),患者治疗依从性、满意率均较治疗前提高(x2=10.255、9.143,均P＜0.01).结论 地特胰岛素联合阿卡波糖可有效控制血糖,低血糖发生率低,不增加体质量,患者依从性好,满意度高.

Cinical observation of insulin detemir combined with acarbose in curing type 2 diabetic patients

Objective To observe the effect of insulin detemir combined with acarbose in treatment of patients with type 2 diabetes （T2DM）. Methods 32 T2DM patients whose blood glucose control was poor receiving twice daily isophane protamine biosynthetic human insulin（ Novolin 30R） combined or not combined with oral hypoglycemic drugs, were switched to receive insulin detemir injection once daily and oral acarbose three times daily for 12 weeks. By self-contrasted method, observed blood glucose before and after three meals, before sleeping, glycated hemoglobin （ HbA 1 c ）, change of body mass index （ BMI）, incidence of hypoglycemia, compliance and satisfaction of patients （by questionnaire） before and after treatment. Results After treatment, the blood glucose before and after three meals,before sleeping and HbAlc declined sigmifieatly （t = 11. 212,14. 997,10. 863,17. 950,11. 108,14. 034, 12. 422,22. 764,all P 〈0.01 ）compared to state before treatment. The rate of hypoglycemia in the day was 3.1%, without nocturnal symptoms of hypoglycemia. BMI had certain declining, but there was no statistical significance （ P 〉 0.05 ）. The compliance and satisfaction of patients were in a higher rate （ X2 = 10. 255,9. 143, all P 〈 0.01 ）. Conclusion Insulin detemir combined with acarbose could effectively control the blood glucose,incidence of hypoglycemia ,without increasing body mass, achieve good compliance and satisfaction of patients.