胰岛素类似物联合口服降糖药治疗2型糖尿病的疗效及安全性观察

发布时间：2018-01-28 19:03

本文关键词： 地特胰岛素甘精胰岛素门冬胰岛素30 2型糖尿病　出处：《重庆医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的观察临床三种常用的胰岛素类似物在经生活方式干预及口服药物仍降糖效果不佳的2型糖尿病(T2DM)中启用,并继续联合口服降糖药物(OADs)的有效性及安全性,为临床T2DM的胰岛素起始治疗方案选择提供更多依据。方法入选受试者为经生活方式干预及口服药物仍降糖效果不佳的T2DM患者,共为：79例,分为3组,一组25人,给予加用地特胰岛素；一组纳入29人,给予加用甘精胰岛素；一组25人,给予门冬胰岛素30(BIAsp30)治疗,每组联合口服降糖药(OADs),治疗时间为4个月。测量治疗前后患者的空腹血糖(FBG)、餐后血糖(PBG)、糖化血红蛋白(HbAlc)、体重指数(BMI),计算出三组FBG、PBG、HbAlc的变化差值,并统计出HbAlc的达标比率(HbAlc达标判断标准为7%)和低血糖发生率。结果治疗前各组HbAlc、血糖测量值无显著差异(P0.05)。经4个月治疗,三组HbAlc 、FBG、PBG均较入组前明显下降(P0.01),组间下降幅度无显著差异(P0.05)。3组治疗前后BMI无显著变化(P0.05)。地特胰岛素组、甘精胰岛素组、BIAsp30组HbAlc达标率分别为44%、60%、53%,各组无显著差异(P0.05)。地特胰岛素组、甘精胰岛素组、BIAsp30组低血糖发生率分别为12%、7%、20%,3组低血糖发生率比较无显著差异(P0.05),无严重低血糖发生。结论经生活方式干预及口服药物仍降糖效果不佳的T2DM患者,在分别联合上述三种胰岛素类似物后,可达到相同的血糖控制效果,体重无明显改变、低血糖发生率低。
[Abstract]:Objective to observe the use of three common insulin analogues in type 2 diabetes mellitus (T2DM), which were treated by lifestyle intervention and oral administration. The efficacy and safety of combined oral hypoglycemic drug OADswere also continued. Methods 79 patients with T2DM were enrolled in this study. They were divided into 3 groups, 25 persons in each group were treated with gatite insulin; A group of 29 people were given plus insulin glargine; A group of 25 people were treated with insulin asparagus 30 BIAsp30 (each group combined with oral hypoglycemic drug OADs). The duration of treatment was 4 months. Fasting blood glucose (FBGG), postprandial blood glucose (PBGG), glycosylated hemoglobin (HbAlcn) and body mass index (BMI) were measured before and after treatment. The variation difference of HbAlc in three groups of FBGN PBGN was calculated. The rate of meeting the standard of HbAlc and the incidence of hypoglycemia were found to be 7% and 7% respectively. Results before treatment, the rate of HbAlc in each group was determined. There was no significant difference in blood glucose measurement value (P 0.05). After 4 months of treatment, the levels of HbAlc in the three groups were significantly lower than those before entering the group (P 0.01). There was no significant difference in the decrease of BMI between the two groups. There was no significant change in BMI before and after treatment in P0.050.The insulin group and the insulin glargine group had no significant change before and after treatment. The rate of reaching the standard of HbAlc in the BIAsp30 group was 440.60 and 553, respectively. There was no significant difference between the three groups (P0.050.The insulin group and insulin glargine group). The incidence of hypoglycemia in the BIAsp30 group was 12 / 7 and 20 / 20 respectively. There was no significant difference in the hypoglycemia rate among the three groups (P0.05). There is no serious hypoglycemia. Conclusion the patients with T2DM who still have poor hypoglycemic effect after lifestyle intervention and oral administration can achieve the same blood glucose control effect after the combination of the three insulin analogs mentioned above. There was no significant change in body weight and low incidence of hypoglycemia.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.1

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