地特胰岛素联合低剂量二甲双胍、阿卡波糖治疗老年2型糖尿病超重与肥胖患者疗效及安全性的观察

目的 探讨老年T2DM超重、肥胖患者在口服降糖药基础上加用每日一次地特胰岛素（Det）治疗的临床疗效及安全性. 方法 93例老年T2DM超重、肥胖患者随机分为A、B组.A组口服二甲双胍＋阿卡波糖（Met＋ Acarbose）;B组二甲双胍＋阿卡波糖＋Det （Met＋ Acarbose＋ Det）,疗程24周.观察两组治疗前后FPG、2hPG、BMI、HbA1c及低血糖发生率等情况. 结果 24周后,B组FPG、2hPG、HbA1 c、BMI较基线及A组降低（P＜0.05）,且无夜间低血糖发生. 结论 Det联合低剂量二甲双胍＋阿卡波糖可有效控制老年T2DM超重、肥胖患者血糖,优于单纯口服给药,并能控制体重,且无夜间低血糖发生.

Clinical therapeutic effects and safety of insulin detemir combination with low dosage of metformin and acarbose on elderly overweight and obese type 2 diabetic patients

Objective To observe the clinical efficacy and safety of once daily insulin detemir combined with oral hypoglycemic agents in overweight and obese patients with type 2 diabetes. Methods 93 cases of elderly overweight and obese patients with type 2 diabetes were randomly divided into 2 groups. Group A was treated with oral metformin and acarbose while patients in group B were given insulin detemir except metformin and acarbose. Indicators, such as FPG, 2 hPG, BMI, HbAlc and hypoglycemia incidence were recorded before and after treatment for 24 weeks. Results During the 24 weeks following-up,the FPG, 2 hPG, HbAlc, and BMI in group B decreased significantly when compared with baseline（P〈0. 05）, and those in group A（P〈0.05）, no cases of nocturnal hypoglycemia occurred. Conclusion Combination of insulin detemir with low dose me tformin and acarbose could control the blood sugar effectively in elderly overweight and obese patients with type 2 diabetes, which was better than that of pure oral dosing, and could control weight and prevent the incidence of nocturnal hypoglycemia.