用诺和锐和诺和灵R持续皮下输注治疗2型糖尿病的疗效对比

目的　比较速效胰岛素类似物 (诺和锐 )和短效人胰岛素 (诺和灵R)用外置的胰岛素泵持续皮下输注 (CSⅡ )治疗 2型糖尿病 (T2DM )的疗效。　方法　该研究为持续 2 4周随机、开放、交叉实验 ,2 9例T2DM患者 ,随机分为诺和锐组和诺和灵R组 ,诺和锐为餐前即刻输注 ,诺和灵R为餐前 30min输注 ,12周治疗后两组交换用药。观察两种不同治疗方式患者糖化血红蛋白 (HbA1c)、8个时点 (3餐前后、睡前、凌晨 2点 )血糖、低血糖及胰岛素泵的安全性的差异。　结果　接受诺和锐治疗组的患者HbA1c指标好于诺和灵R组 (P <0 0 1)。 8个时点血糖检测显示诺和锐组三餐后及睡前血糖水平均低于诺和灵R组 (P <0 0 1～ 0 0 5 )。两组患者胰岛素用量、低血糖发生率及胰岛素泵的安全性均无差异。　结论　诺和锐与诺和灵R均可安全有效的降低血糖及HbA1c ,诺和锐用于CSⅡ控制餐后血糖更具优点。

A comparison between insulin aspart and human regular insulin via continuous subcutaneous insulin infusion pump in patients with type 2 diabetes

Objective To compare the safety and efficiency between insulin aspart(IAsp) and human regular insulin(HRI) in elderly patients with type 2 diabetes via continuous subcutaneous insulin infusion (CSII) pump Methods In the 24 weeks of randomized, opened and crossed trial, 29 patients on CSII with adequate blood glucose control received either IAsp or HRI for 12 weeks, followed by the two groups of patients exchanging the two drugs for another 12 weeks Bolus HRI doses were administered 30 min before meals and Iasp immediately before meals Efficacy and safety measures included hemoglobin A1c (HbA 1c) at baseline and endpoint, eight point(before and after three meals, at bedtime and 2AM)blood glucose profiles, and frequency of hypoglycemia and pump catheter occlusion Results Insulin aspart was associated with a significantly lower HbA 1c than human regular insulin( P <0 01) Fasting or 2AM serum glucose levels were similar between the two therapies The glucose concentrations at three postprandial or bedtime were significantly lower during treatments with insulin aspart( P <0 01 or P <0 05) No differences between the two treatments were observed in basal or bolus insulin dosages and the incidence of hypoglycemia and pump occlusions Conclusions Insulin aspart in CSII is as efficacious and well tolerated as HRI, but insulin aspart provides better postprandial glucose control than human regular insulin