甘精胰岛素不同给药时间治疗1型糖尿病的疗效及安全性研究

目的：探讨不同时间皮下注射甘精胰岛素治疗1型糖尿病的疗效及安全性。方法选取50例1型糖尿病患者，应用门冬胰岛素联合甘精胰岛素进行治疗，在甘精胰岛素不改变用量前提下，给药时间由22：00调整到18：00前后，比较时间调整前后3 d患者空腹血糖（ FBG）、早中晚餐后2 h血糖（2hPG）和午餐前血糖的变化情况、门冬胰岛素的用量及午餐前患者低血糖事件发生情况。结果甘精胰岛素调整用药时间后，患者午餐前血糖调整至理想水平，FBG（7．28±2．13）mmol/L比（8．33±2．20）mmol/L、午餐后2hPG下降显著（8．61±2．59）mmol/L 比（9．70±1．75）mmol/L（U＝2．425、3．034，均 P＜0．05），早餐后2hPG （8．27±2.02）mmol/L比（8．56±2．33）mmol/L和晚餐后2hPG（9．54±1．55）mmol/L比（9．61±1．75）mmol/L变化均不明显（均P＞0．05）；门冬胰岛素早餐前用量减少，午餐前和晚餐前用量增加；午餐前低血糖事件显著减少（χ2＝4．105、5．005，均P＜0．05）。结论甘精胰岛素联合门冬胰岛素治疗1型糖尿病患者，在不改变甘精胰岛素用量情况下，给药时间由22：00调整为18：00，可平稳降低空腹血糖，减少午餐前低血糖的发生。

Research on the efficacy and safety of insulin glargine in different administration time for treatment of type 1 diabetes

Objective To explore the clinical efficacy and safety of insulin glargine in different administra-tion time for treatment of type 1 diabetes .Methods 50 patients with type 1 diabetes were given insulin aspart and in-sulin glargine treatment scheme , under the premise of not change insulin glargine dosage , delivery time of insulin glargine varied from 22：00 to 18：00,and fasting blood glucose（FBG）,2 hours postprandial blood glucose（2hPG）, blood glucose and occurrence of hypoglycemia before lunch , amount of insulin aspart were noted and compared between before and after the adjustment .Results After adjustment of insulin glargine′s medication time , patients′blood sugar before lunch adjusted to desired level ,FBG（7.28 ±2.13） mmol/L vs.（8.33 ±2.20） mmol/L,2hPG （8.61 ±2.59）mmol/L vs.（9.70 ±1.75） mmol/L decreased significantly after lunch compared with pre-adjustment （U=2.425,3.034,all P〈0.05）,2hPG after breakfast （8.27 ±2.02） mmol/L vs.（8.56 ±2.33） mmol/L and dinner 2hPG （9.54 ±1.55）mmol/L vs.（9.61 ±1.75）mmol/L without statistically significant difference （all P〉0.05）.Dosage of insulin aspart before breakfast reduced , and increased before lunch and dinner .Incidence of hypoglycemia before lunch significantly decreased （χ2 =4.105,5.005,all P〈0.05）.Conclusion Insulin glargine combined with insulin aspart in the treatment of type I diabetes ,with no change in insulin glargine dosage ,and delivery time changed from 22：00 to 18：00,which could reduce FBG ,reduce occurrence of hypoglycemia before lunch ,and stable in blood sugar controlling .