甘精胰岛素治疗对糖尿病患者生活质量的影响

糖尿病不仅给患者带来巨大的健康负担,还会严重影响患者的生活质量。糖尿病治疗的主要目的是为了降低糖尿病患者并发症的发生率和死亡率,但是在治疗过程中可能引起患者生活质量的下降。甘精胰岛素是胰岛素的类似物,可以使患者在获得较好血糖控制的同时较少发生低血糖反应。研究显示与中效胰岛素(NPH)或者一些其他1型糖尿病常用胰岛素治疗方案相比,甘精胰岛素的治疗可以改善1型和2型糖尿病患者的治疗满意度、总体情感和健康感觉。在口服降糖制剂的基础上加用甘精胰岛素可提高治疗满意度。     

甘精胰岛素联合二甲双胍治疗2型糖尿病

56例口服降糖药控制不理想的2型糖尿病患者按随机分为甘精胰岛素治疗组和诺和灵N组.结果治疗后甘精胰岛素组在血糖达标时间、空腹血糖、日内血糖漂移、低血糖发生率方面均低于中效胰岛素组(P＜0.05).结论应用甘精胰岛素联合二甲双胍片降糖效果显著并能减少夜间低血糖发生.     

甘精胰岛素与NPH重组人胰岛素低血糖观察

采用随机、开放、NPH重组人胰岛素平行对照方法,将70例口服降糖药治疗效果欠佳的2型糖尿病患者随机分入甘精胰岛素组(n=35)和NPH重组人胰岛素组(n=35),观察二组低血糖的发生率.结果甘精胰岛素组低血糖的发生率比NPH重组人胰岛素组少的多(甘精胰岛素组发生低血糖3例,发生率8.6%;NPH重组人胰岛素组发生低血糖11例,发生率31.4%,χ2=5.72,P＜0.05).结论甘精胰岛素的应用能减少低血糖事件的发生,使患者依从性提高,有利于血糖的控制.     

甘精胰岛素在脆性糖尿病患者治疗中的疗效观察

收集19例使用预混胰岛素皮下注射治疗的脆性糖尿病患者给予甘精胰岛素加超短效胰岛素多点皮下注射治疗,比较治疗前后的空腹血糖、餐后2h血糖、糖化血红蛋白、血糖波动程度、低血糖发生率。结果：使用甘精胰岛素加超短效胰岛素多点皮下注射可以使血糖控制不良的脆性糖尿病患者的血糖得到有效控制,降低血糖波动幅度,减少低血糖发生率。结论：脆性糖尿病患者,联合餐前超短效胰岛素的应用,甘精胰岛素较预混胰岛素控制血糖疗效更佳。     

预混胰岛素治疗血糖控制不佳的2型糖尿病转为甘精胰岛素联合口服药治疗临床应用

50例每日两次预混胰岛素治疗欠佳的2型糖尿病患者转为每日一次甘精胰岛素联合二甲双胍治疗12周后对比HbA1c、FPG、低血糖发生、胰岛素用量;结果：转为甘精胰岛素＋二甲双胍治疗后HbA1c、FPG均较前显著降低（P〈0．01）,低血糖发生显著减少、胰岛素用量较前减少。结论：预混胰岛素治疗欠佳的2型糖尿病患者转为每日一次甘精胰岛素联合二甲双胍可提供更佳的血糖控制,给患者带来更多的获益。     

甘精胰岛素联合二甲双胍治疗2型糖尿病

56例口服降糖药控制不理想的2型糖尿病患者按随机分为甘精胰岛素治疗组和诺和灵N组。结果治疗后甘精胰岛素组在血糖达标时间、空腹血糖、日内血糖漂移、低血糖发生率方面均低于中效胰岛素组（P〈0．05）。结论应用甘精胰岛素联合二甲双胍片降糖效果显著并能减少夜间低血糖发生。     

甘精胰岛素联合阿卡波糖治疗老年2型糖尿病的临床评估

目的探讨甘精胰岛素联合阿卡波糖治疗老年2型糖尿病的疗效和安全性。方法对老年2型糖尿病分别给予甘精胰岛素和甘精胰岛素联合阿卡波糖治疗,观察其治疗效果和分析用药安全性。结果两组在血糖控制时间、空腹血糖、糖化血红蛋白、胰岛素用量、空腹C肽和低血糖反应等方面进行比较,差异有统计学意义(P0.05)。结论使用甘精胰岛素联合阿卡波糖治疗老年2型糖尿病,能明显加快血糖达标速度,平稳有效降低血糖,减少胰岛素的用量,降低治疗风险,促进患者恢复。     

阿卡波糖联合甘精胰岛素对老年2型糖尿病血糖的影响

选取2019年7月~2020年3月92例老年T₂DM患者,随机平分单一组以甘精胰岛素治疗,联合组以阿卡波糖+甘精胰岛素治疗。结果:2组总有效率对比无显著差异(P>0.05);与单一组比较,治疗后联合组餐后2h血糖(2hPG)、空腹血糖(FPG)、糖化血红蛋白(HbA_1c)较低(P<0.05);低血糖发生率2.17%及胃肠道反应10.87%低于单一组19.57%、28.26%(P<0.05)。结论:阿卡波糖联合甘精胰岛素治疗老年T₂DM患者效果确切,可有效控制血糖水平,减少低血糖、胃肠道反应发生。     

甘精胰岛素与NPH重组人胰岛素低血糖观察

采用随机、开放、NPH重组人胰岛素平行对照方法，将70例口服降糖药治疗效果欠佳的2型糖尿病患者随机分入甘精胰岛素组（n=35）和NPH重组人胰岛索组（n=35），观察二组低血糖的发生率。结果甘精胰岛索组低血糖的发生率比NPH重组人胰岛素组少的多（甘精胰岛素组发生低血糖3例，发生率8．6％；NPH重组人胰岛素组发生低血糖11例．发生率31．4％，X^2=5．72，P〈0．05）。结论甘精胰岛素的应用能减少低血糖事件的发生，使患者依从性提高，有利于血糖的控制。     

甘精胰岛素对老年2型糖尿病患者降糖的疗效观察

选取68例老年(年龄>65岁)2型糖尿病患者,起始三天停用原来降糖药物,第四天起给予中效胰岛素(NPH)联合餐前短效胰岛素皮下注射强化胰岛素治疗,血糖相对平稳后,分为二组,分别采用睡前注射甘精胰岛素联合那格列奈口服和预混30R胰岛素皮下注射治疗12周。比较治疗后两组血糖达标时间、平均空腹血糖、血糖漂移、胰岛素用量、低血糖发生率。结果:甘精胰岛素组在血糖达标时间、治疗后空腹血糖、日内血糖漂移、低血糖发生率方面均低于预混胰岛素组(P<0.05)。结论:老年冠心病合并2型糖尿病患者中,甘精胰岛素联合那格列奈治疗,疗效确切、易于接受、低血糖反应少。     

拉米夫定治疗慢性乙型肝炎病毒感染的经济效益

目的　评估慢性乙型肝炎及其并发症的经济负担和拉米夫定治疗的临床效果与经济效益。方法　根据慢性乙型肝炎、代偿性肝硬化、失代偿性肝硬化和肝癌病人的年直接医疗费用、直接非医疗费用以及间接费用计算其经济负担。同时根据亚洲拉米夫定多中心临床研究和 15个国家临床研究的综合数据来计算节省的费用。结果　不同肝病阶段的病人年经济负担不同 ,慢性乙型肝炎为 2 0 478元 ,代偿性肝硬化为 3 63 2 5元 ,失代偿性肝硬化为 3 675 9元 ,肝细胞肝癌为 3 82 69元。拉米夫定治疗 1年后 ,使医疗费用得到部分节省。结论　慢性乙型肝炎病毒感染者经济负担较重 ,而采用拉米夫定治疗则可降低病人的经济负担     

重庆市四区县肺结核患者经济负担分析

目的: 了解重庆市经济欠发达(简称“欠发达”)区县肺结核患者的经济负担,为优化肺结核患者医疗保险政策提供数据支持。 方法: 采用横断面的研究,选择重庆市黔江区、丰都县、开州区和巫山县结核病定点医院2019年6月至2020年6月间登记治疗的326例活动性肺结核患者,通过问卷调查,以及收集《医院信息系统》中的诊疗信息和费用信息,对患者因病发生的各项费用及个人负担进行分析。 结果: 326例患者平均疗程为180.0(178.0,210.0)d,确诊前的直接医疗费用为1600.0(920.0,3500.0)元,确诊后的直接医疗费用为2479.0(1218.9,5709.6)元。患病后的直接非医疗费用为1300.0(400.0,3000.0)元,因治疗肺结核损失的间接费用为3850.0(500.0,15000.0)元,总费用为14156.8(6904.7,28133.9)元。80.98%(264/326)的患者因治疗肺结核发生家庭灾难性支出。 结论: 重庆市欠发达地区的肺结核患者经济负担较重,现行医疗保险报销政策不能完全缓解患者经济负担,应考虑进一步完善重庆市结核病医疗保险报销政策,降低家庭灾难性支出。     

肺癌合并2型糖尿病围手术期血糖管理

目的探讨肺癌合并2型糖尿病患者术后不同血糖控制方案的疗效。方法选择61例肺癌合并2型糖尿病的患者,随机分为3组:静脉输注组、胰岛素泵组和甘精胰岛素组。于术后检测3组各项临床指标。结果治疗后甘精胰岛素组在血糖控制时间、治疗后日平均血糖、胰岛素日使用量、低血糖的发生率及血糖波动程度、胰岛素抵抗指数等方面与胰岛素泵组无差异,但均显著低于静脉胰岛素输注组。结论肺癌合并2型糖尿病患者在围术期采用甘精胰岛素和胰岛素泵治疗均可安全有效的控制血糖。     

Insulin therapy in type 2 diabetes patients failing oral agents: cost-effectiveness of biphasic insulin aspart 70/30 vs. insulin glargine in the US

OBJECTIVES: To project the long-term clinical and economic outcomes of treatment with biphasic insulin aspart 30 (BIAsp 70/30, 30% soluble and 70% protaminated insulin aspart) vs. insulin glargine in insulin-na?ve type 2 diabetes patients failing to achieve glycemic control with oral antidiabetic agents alone (OADs). METHODS: Baseline patient characteristics and treatment effect data from the recent 'INITIATE' clinical trial served as input to a peer-reviewed, validated Markov/Monte-Carlo simulation model. INITIATE demonstrated improvements in HbA1c favouring BIAsp 70/30 vs. glargine (-0.43%; p < 0.005) and greater efficacy in reaching glycaemic targets among patients poorly controlled on OAD therapy. Effects on life expectancy (LE), quality-adjusted life expectancy (QALE), cumulative incidence of diabetes-related complications and direct medical costs (2004 USD) were projected over 35 years. Clinical outcomes and costs were discounted at a rate of 3.0% per annum. Sensitivity analyses were performed. RESULTS: Improvements in glycaemic control were projected to lead to gains in LE (0.19 +/- 0.24 years) and QALE (0.19 +/- 0.17 years) favouring BIAsp 70/30 vs. glargine. Treatment with BIAsp 70/30 was also associated with reductions in the cumulative incidences of diabetes-related complications, notably in renal and retinal conditions. The incremental cost-effectiveness ratio was $46 533 per quality-adjusted life year gained with BIAsp 70/30 vs. glargine (for patients with baseline HbA1c >/= 8.5%, it was $34 916). Total lifetime costs were compared to efficacy rates in both arms as a ratio, which revealed that the lifetime cost per patient treated successfully to target HbA1c levels of <7.0% and 相似文献   

安徽绩溪县晚期血吸虫病患者经济负担与影响因素

目的 探讨安徽绩溪县晚期血吸虫病(晚血)患者医疗救治的家庭经济负担状况及其相关影响因素,为制定医疗救治政策提供科学依据.方法 设计晚期血吸虫病患者的经济负担与影响因素个案调查表,由2名经过培训的医师进行逐项调查,调查内容包括患者基本信息、近三年其它疾患治疗和经济负担、晚血治疗直接费用和间接费用及救助情况、家庭经济背景情...     

Insulin glargine: a new once-daily basal insulin for the management of type 1 and type 2 diabetes mellitus

Optimal glucose control is the primary goal for treating diabetes mellitus and preventing long-term complications of diabetes, such as coronary heart disease, nephropathy, neuropathy and retinopathy. Insulin glargine is a novel, long-acting human insulin analog that is indicated in type 1 diabetic patients aged >or=6, or in type 2 diabetic patients who require basal insulin for glycemic control. Insulin glargine is a recombinant insulin with a modified structure that allows it to dissolve in an acidic solution, but to precipitate in the physiological subcutaneous tissue forming a depot effect. In contrast to Neutral Protamine Hagedorn (NPH) insulin, insulin glargine has a slower onset, a longer duration of action, and no peak in metabolic activity. Once-daily subcutaneous administration of insulin glargine at bedtime has comparable efficacy to that of NPH insulin once or twice daily when used in combination with bolus insulin in type 1 diabetic patients, or in conjunction with oral antidiabetic drugs in type 2 diabetic patients. Overall, insulin glargine has similar adverse effects when compared with NPH insulin. Insulin glargine has been associated with less nocturnal hypoglycemia and improved treatment satisfaction in several clinical trials with durations of < 52 weeks. Pharmacoeconomic analysis comparing insulin glargine with other intermediate- or long-acting insulin preparations used as basal insulin therapy has not been performed. In summary, insulin glargine offers a promising alternative as a once-daily basal insulin therapy in patients with type 1 and type 2 diabetes.     

甘精胰岛素加三餐前短效胰岛素和胰岛素泵短期强化治疗对2型糖尿病疗效比较

目的探讨甘精胰岛素联合三餐前短效胰岛素和胰岛素泵治疗对口服降糖药效果不佳的2型糖尿病的疗效、安全性及性价比。方法60例T2DM患者分为甘精胰岛素注射（甘精组）和胰岛素泵（CSII组）,两组的年龄、BMI、FDP、FPG、2hC-P、2hPG、HbA1C差异无统计学意义（P〉O．05）。结果甘精组和CSII组治疗均有效,FPG、2hPG均较治疗前明显下降,FC-P、2hC-P均较治疗前明显升高（P〈0．05）。两组达到相同血糖水平所需的治疗时间以及低血糖发生率无统计学差异（P〉O．05）,但甘精组的胰岛素用量明显低于CSII组（P〈0．05）。结论甘精胰岛素配合三餐前短效胰岛素能有效模拟人生理胰岛素分泌,有效控制高血糖,且效价比高于胰岛素泵。     

Flexibly timed once‐daily dosing with degludec: a new ultra‐long‐acting basal insulin

Insulin treatment in type 1 and type 2 diabetes (T1D and T2D) is highly efficacious, but in practice, non‐adherence and ineffective dose titration limit its effectiveness. Barriers to more effective insulin treatment are numerous, including hypoglycaemia, fear of hypoglycaemia and concern about weight gain. The regular treatment timing needed with conventional basal insulins [neutral protamine Hagedorn (NPH) insulin and the first‐generation analogues glargine and detemir] may also make adherence to these treatments problematic for many patients. Indeed, surveys indicate that the rigidity of this schedule induces some patients with T1D and T2D to omit insulin doses. Degludec is a novel, ultra‐long‐acting basal insulin analogue that is as effective as insulin glargine, but significantly reduces patients' risk of nocturnal hypoglycaemia. Because of its peakless, extended and highly predictable glucose‐lowering effect, once‐daily dosing on a flexible schedule may be feasible with degludec. Studies testing this possibility suggest that degludec tolerates day‐to‐day variation in dose timing while maintaining full efficacy and low risk of nocturnal hypoglycaemia. Degludec would appear to be an appropriate choice for patients being considered for a basal analogue, and it may be particularly well suited to patients with unpredictable social or work schedules, those who travel frequently and those who find rigid scheduling of their insulin injections a burden or barrier to regular treatment.     

2型糖尿病患者围手术期甘精胰岛素与胰岛素泵的疗效比较

目的观察甘精胰岛素在2型糖尿病患者围手术期的降糖效果和安全性。方法将准备手术治疗的2型糖尿病患者45例分为甘精胰岛素输注组（甘精组,20例）和胰岛素泵持续皮下输注组（CSII组,25例）。比较两组降糖效果、血糖控制时间、低血糖发生率、切口感染发生率及降血糖费用等方面的差异。结果两组治疗后血糖均显著下降（P〈0．01）,达到目标血糖值;血糖、血糖控制时间、低血糖发生率及切口感染发生率两组比较无统计学差异（P〉0．05）;甘精组降血糖费用显著低于CSII组（P〈0．01）。结论围手术期胰岛素治疗中,采用甘精胰岛素可以快速、有效、安全、经济地控制血糖。