那格列奈联合甘精胰岛素治疗老年2型糖尿病的疗效及安全性

目的:探讨那格列奈联合甘精胰岛素对老年2型糖尿病病人的疗效及安全性。方法:血糖控制欠佳的年龄≥70 a的老年2型糖尿病病人60例,分成2组。试验组30例,男性23例,女性7例,年龄(77±s 11)a,予那格列奈加甘精胰岛素注射液治疗。对照组30例,男性24例,女性6例,年龄(78±10)a,予精蛋白锌重组人胰岛素混合注射液治疗。疗程均8 wk,测定治疗前后空腹血糖、餐后2 h血糖、糖化血红蛋白的变化并观察不良反应的发生率。结果:治疗后试验组与对照组空腹血糖分别下降(1．8±1．2)和(1．8±1．3)mmol·L-1,餐后2 h血糖分别下降(3．9±1．2)和(3．8±1．2)mmol·L-1,糖化血红蛋白下降(1．2±0．9)％和(1．2±1．0)％,与治疗前比较差异有非常显著意义(P<0．01),2组间比较无显著差异(P>0．05)。试验组发生低血糖5例,明显低于对照组19例。结论:在老年2型糖尿病病人中那格列奈联合甘精胰岛素治疗降血糖效果好,使用简单、方便,低血糖发生率低、安全性好。

Therapeutic effect and safety of nateglinide combined with insulin glargine in treatment of elder patients with type 2 diabetes

AIM: To evaluate the efficacy and safety of nateglinide combined with insulin glargine in treatment of elder patients with type 2 diabetes. METHODS: Sixty elder patients over 70 a with type 2 diabetes under unsatisfied blood glucose control were divided into 2 groups. Thirty patients (M 23, F 7; age (77±s 11) a) in the trial group were treated by nateglinide with insulin glargine injection. The other 30 patients (M 24, F 6; age (78±10) a) in the control group were treated by mixed protamine zinc recombinant human insulin injection. Both groups were under treatment for 8 wk as a course, with the values of fasting blood glucose (FBG), 2 h postprandial blood glucose (2hPG) and glycosylated hemoglobin (HbA1c) before and after the treatment as well as adverse reactions. RESULTS: After treatment, the levels of FBG, 2hPG, and HbA1c in trial and control groups decreased (1.8±1.2) vs (1.8±1.3) mmol·L-1, respectively, while 2hPG decreased (3.9±1.2) vs (3.8±1.2) mmol·L-1 and HbA1c (1.2±0.9) % vs (1.2±1.0) %, respectively; showing significant difference in comparison with those before the treatment (P < 0.01), but with no significant difference between the two groups (P > 0.05). The main adverse reaction was hypoglycemia, with 5 in trial group and 19 in control group (P< 0.01). CONCLUSION: Nateglinide with insulin glargine can control the blood glucose effectively in elder patients with type 2 diabetes possessing low incidence of hypoglycemia and high safety accompanied by simple and easy way in application.