双相门冬胰岛素30和预混人胰岛素30/70短期疗效的动态血糖监测比较

目的 比较每日2次注射双相门冬胰岛素30(BIAsp 30)和预混人胰岛素30/70(BHI 30)治疗老年2型糖尿病(T2DM)的血糖控制和血糖波动情况.方法 选择52例口服降糖药效果不佳的老年T2DM患者随机分为两组,分别每日早、晚餐前皮下注射BIAsp 30和BHI 30,三餐前及睡前指尖血糖达标后进行动态血糖监测,比较两组整体血糖控制水平、血糖波动系数、餐后血糖漂移、低血糖发生等情况.结果 两组三餐前、午餐后及平均血糖水平的差异无统计学意义(均P＞0.05).BIAsp 30组较BHI 30组血糖波动系数减小(1.69±0.42)mmol/L vs.(2.07±0.51)mmol/L,t=-3.013,P＜0.01];早、晚餐后血糖漂移幅度减小,分别为(2.89±1.32)mmol/L vs.(3.83±1.18)mmol/L,t=-2.705,P＜0.01]、(2.69±1.37)mmol/L vs.(3.55±1.40)mmol/L,t=-2.232,P＜0.05];血糖漂移至11.1 mmol/L以上的时间百分数减低(621±6.04)% vs.(10.0l±6.80)%,t=-2.132,P＜0.05].BIAsp 30组较BHI 30组低血糖频率减少,但两组差异无统计学意义(P＞0.05).结论 对于老年T2DM患者,每日2次注射BIAsp 30和BHI 30同样有效,但前者能更明显降低餐后血糖和减少血糖波动,减少低血糖风险.

Abstract：

Objective To compare the blood glucose levels and variability of premixed insulin aspart (BIAsp 30) with human insulin premix (BHI 30) used in a twice a day injection regimen in elderly type 2 diabetes patients. Methods 52 cases of inadequate glycemia controlled by oral anti-diabetic drugs were randomly divided into two groups, treated on a twice-daily regimen with BIAsp 30 (n=26) and BHI 30 (n=26) respectively. After achieving the target goal, a continuous glucose monitoring system (CGMS) was used to compare the blood glucose levels, blood glucose fluctuant coefficient (BGFC), postprandial glucose excursion (PPGE), and occurrence of hypoglycemia.Results BIAsp 30 was as effective as BHI 30 in controling glycaemia. Detected by CGMS, there was no statistical differences in blood glucose levels among pre-three main meals, post-lunch and the mean blood glucose (MBG) (all P＞0.05). The BGFC levels were significantly lower in the BIAsp 30 group than in the BHI 30 group (1.69±0.42) mmol/L vs. (2.07 ±0.51)mmol/L,t=-3.013,P＜0.01]. The blood glucose increment over breakfast, dinner and the percentage of time at hyperglycaemia (BG ＞11.1 mmol/L) were lower in the BIAsp 30 group than in the BHI 30 group(2.89± 1.32) mmol/Lvs.(3.83 ± 1.18) mmol/L, t=-2.705, P＜0.01; (2.69 ± 1.37) mmol/L vs. (3.55 ± 1.40) mmol/L, t=-2.232, P＜0.05; (6.21 ± 6.04)% vs. (10.01 ± 6.80)%, t=-2.132, P＜0.05]. The frequency of hypoglycemia was lower in the BIAsp 30 group than in the BHI 30 group, but there was no statistical difference (P＞0.05). Conclusion Pre-meal injection of BIAsp 30 in a twice-daily regimen could significantly improve the control of postprandial glucose level and reduce the overall glucose excursions so as to lower the risk of hypoglycaemia when compared to BHI 30.

Comparison on the efficacy of biphasic insulin aspart 30 and premixed human insulin 30/70 through continuous glucose monitoring system

Objective To compare the blood glucose levels and variability of premixed insulin aspart (BIAsp 30) with human insulin premix (BHI 30) used in a twice a day injection regimen in elderly type 2 diabetes patients. Methods 52 cases of inadequate glycemia controlled by oral anti-diabetic drugs were randomly divided into two groups, treated on a twice-daily regimen with BIAsp 30 (n=26) and BHI 30 (n=26) respectively. After achieving the target goal, a continuous glucose monitoring system (CGMS) was used to compare the blood glucose levels, blood glucose fluctuant coefficient (BGFC), postprandial glucose excursion (PPGE), and occurrence of hypoglycemia.Results BIAsp 30 was as effective as BHI 30 in controling glycaemia. Detected by CGMS, there was no statistical differences in blood glucose levels among pre-three main meals, post-lunch and the mean blood glucose (MBG) (all P＞0.05). The BGFC levels were significantly lower in the BIAsp 30 group than in the BHI 30 group (1.69±0.42) mmol/L vs. (2.07 ±0.51)mmol/L,t=-3.013,P＜0.01]. The blood glucose increment over breakfast, dinner and the percentage of time at hyperglycaemia (BG ＞11.1 mmol/L) were lower in the BIAsp 30 group than in the BHI 30 group(2.89± 1.32) mmol/Lvs.(3.83 ± 1.18) mmol/L, t=-2.705, P＜0.01; (2.69 ± 1.37) mmol/L vs. (3.55 ± 1.40) mmol/L, t=-2.232, P＜0.05; (6.21 ± 6.04)% vs. (10.01 ± 6.80)%, t=-2.132, P＜0.05]. The frequency of hypoglycemia was lower in the BIAsp 30 group than in the BHI 30 group, but there was no statistical difference (P＞0.05). Conclusion Pre-meal injection of BIAsp 30 in a twice-daily regimen could significantly improve the control of postprandial glucose level and reduce the overall glucose excursions so as to lower the risk of hypoglycaemia when compared to BHI 30.