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1.
目的通过比较甘精胰岛素和诺和灵N对口服降糖药血糖控制不佳的老年2型糖尿病患者的治疗效果,探讨甘精胰岛素在老年2型糖尿病患者血糖达标治疗中的临床运用价值。方法44例口服降糖药治疗空腹血糖控制不佳的老年2型糖尿病患者随机分为两组:甘精胰岛素治疗组22例,诺和灵N治疗组22例,治疗12周。观察两组治疗前后的糖化血红蛋白(HbA1c)值、空腹血糖(FBG)、餐后两小时血糖(2hPG)、体重指数(BMI)和每日所需的胰岛素剂量以及两组治疗过程中低血糖发生的频率。结果治疗12周后两组HbA1c、FBG、2hPG与治疗前比较差异有统计学意义(P〈0.05);而两组间HbA1c、2hPG、低血糖事件的发生率比较差异有统计学意义(P〈0.05),每日胰岛素的用量、BMI、FBG比较差异无统计学意义(P〉0.05)。结论加用甘精胰岛素对口服降糖药血糖控制不佳的老年2型糖尿病患者能更有效更安全地控制血糖。  相似文献   

2.
26例应用口服降糖药血糖控制不理想的T2DM患者随机分为甘精胰岛素组(n=13)和预混胰岛素组(n=13)。原口服药不变,每晚10点注射甘精胰岛素。预混胰岛素组采用早、晚餐前30min皮下注射胰岛素,停服原有口服降糖药,若餐后血糖高,加用阿卡波糖片用量(150mg/d)。两组治疗目标为空腹血糖≤6.8mmol/L和餐后2h血糖≤10.0mmol/L。结果治疗后两组血糖均良好下降,但甘精组低血糖事件明显少于预混组。结论甘精胰岛素联合口服降糖药物可以良好地控制高血糖,且低血糖发生率低。  相似文献   

3.
129例T2DM住院患者,使用甘精胰岛素联合口服降糖药治疗。结果治疗后空腹血糖和餐后2小时血糖均显著下降;两两相关检验的显示,甘精胰岛素每日剂量与年龄、体重、身高、糖化血红蛋白、空腹血糖、餐后2小时血糖之间有显著相关性;经回归方程分析,回归系数P值小于0.05的有体重和空腹血糖,甘精胰岛素每日剂量与体重、空腹血糖之间有线性关系。低血糖发生率低。结论使用甘精胰岛素联合口服降糖药治疗2型糖尿病T2DM患者可良好控制血糖。  相似文献   

4.
1例2型糖尿病患者使用口服降糖药物治疗血糖控制不佳,加用甘精胰岛素治疗3个月,空腹静脉血糖由10.6mmol/L降至6.06mmol/L,糖化血糖蛋白由8.7%降至7.9%。患者监测餐后2小时指血血糖11~14mmol/L,加用磷酸西格列汀100mg qd治疗3个月。后监测空腹指血血糖5-7mmol/L,餐后2小时指血血糖8~11mmol/L,复查糖化血红蛋白7.2%。无不良反应和低血糖发生。结论:口服降糖药控制不佳的2型糖尿病患者,调整为甘精胰岛素联合口服降糖药后可有效控制血糖。  相似文献   

5.
目的分析长效甘精胰岛素联合口服降糖药治疗2型糖尿病的效果。方法选取2014年6月—2014年12月在该院接受治疗的30例糖尿病患者为研究对象,在口服降糖药的基础上联合长效甘精胰岛素进行治疗。分别测定长效甘精胰岛素使用前后患者的空腹血糖(FBG)、糖化血红蛋白(Hb Alc)、餐后2h血糖含量(2h BG)、餐后2h C肽(2h CP)、空腹C肽(FCP)、体重指数(BMI)指标的变化情况以及患者低血糖的发生比例。结果口服降糖药联合长效甘精胰岛素治疗4周后,患者的空腹血糖(FBG)、餐后2h血糖含量(2h BG)与单纯口服降糖药相比,差异有统计学意义(P0.05);联合治疗12周之后,患者的空腹血糖(FBG)、餐后2h血糖含量(2h BG)、糖化血红蛋白(Hb Alc)与单纯口服降糖药相比,差异有统计学意义(P0.05),但体重指数(BMI)并无显著差异,患者低血糖的发生率较低。结论长效甘精胰岛素联合口服降糖药可以有效治疗2型糖尿病,患者体重无显著增加,治疗安全性较高,值得在临床上进行推广。  相似文献   

6.
目的观察甘精胰岛素与罗格列酮联用治疗口服降糖药血糖控制差的2型糖尿病患者的疗效及安全性。方法选取口服降糖药血糖控制差的2型糖尿病患者56例,随机分为甘精胰岛素组和中效精蛋白胰岛素组,两组均联合口服罗格列酮。持续观察12周,比较两组空腹血糖(FBG)、餐后2小时血糖(2hPBG)、糖化血红蛋白(HbAlc)、空腹胰岛素(FINS)、胰岛素用量、空腹血糖达标时间、短效胰岛素注射次数、低血糖出现次数,计算胰岛素抵抗指数(IRI),监测肝肾功能、血常规及体重增加情况。结果甘精胰岛素组FBG达标时间、HbAlc水平及出现低血糖次数、体重增加值均低于中效精蛋白胰岛素组(P〈0.05);平均甘精胰岛素使用剂量大于中效精蛋白胰岛素;加用短效胰岛素诺和灵R的量和注射次数及胰岛素总量显著低于中效精蛋白胰岛素组(P〈0.01)。结论口服降糖药疗效差的2型糖尿病患者应用甘精胰岛素联合罗格列酮治疗,有更显著的降糖效果,临床应用安全。  相似文献   

7.
26例应用口服降糖药血糖控制不理想的T2DM患者随机分为甘精胰岛素组(n=13)和预混胰岛素组(n=13).原口服药不变,每晚10点注射甘精胰岛素.预混胰岛素组采用早、晚餐前30min皮下注射胰岛素,停服原有口服降糖药,若餐后血糖高,加用阿卡波糖片用量(150mg/d).两组治疗目标为空腹血糖≤6.8mmol/L和餐后2h血糖≤10.0mmol/L.结果 治疗后两组血糖均良好下降,但甘精组低血糖事件明显少于预混组.结论 甘精胰岛素联合口服降糖药物可以良好地控制高血糖,且低血糖发生率低.  相似文献   

8.
1例2型糖尿病患者使用口服降糖药物治疗血糖控制不佳,且BMI 29. 4kg/m~2,加用甘精胰岛素治疗3个月,指尖血糖由13. 2mmol/L降至6. 5mmol/L,糖化血糖蛋白由8. 9%降至7. 3%。患者监测餐后2小时指血血糖12~15mmol/l,加用沙格列汀5mg qd治疗4个月。后监测空腹指血血糖5~7mmol/L,餐后2小时指血血糖7~10mmol/L,复查糖化血红蛋白7. 3%。体重由83kg降至80kg,无不良反应和低血糖发生,结论:口服降糖药控制不佳的2型糖尿病患者,调整为甘精胰岛素联合口服降糖药后可有效控制血糖,且6月体重无增加。  相似文献   

9.
睡前胰岛素联合口服降糖药治疗2型糖尿病观察   总被引:1,自引:0,他引:1  
目的对54例2型糖尿病口服降糖药仍难以控制血糖的患者予以睡前中效胰岛素(NPH)联合口服降糖药的疗效观察。方法54例2型糖尿病随机分为2组,A组使用格列哌嗪5—10mg tid,中效胰岛素(NPH)每日睡前(22:00)皮下注射。B组使用二甲双胍0.5gtid,半效胰岛素(NPH),每13睡前(22:00)皮下注射,治疗过程中监测5次末梢指尖血糖谱(空腹,三餐后2h,睡前)每周2次,糖化血红蛋白每2个月1次,使空腹血糖≤7.0mmol/L,餐后2h血糖≤10mmol/L。结果2组治疗后FPH,2hPG,HbA1C均显著性下降。2组治疗前后对照差异有非常显著性(P〈0.01)。结论睡前中效胰岛素(NPH)联合口服降糖药物治疗是治疗2型糖尿病的有效方法。  相似文献   

10.
目的 评估糖尿病行长效胰岛素+降糖药口服治疗的效果。方法 选择2020年12月—2021年12月142例糖尿病患者,入院时掷骰子分为单一组与联合组,各71例,单一组行长效胰岛素治疗,联合组增加降糖药口服治疗,比较两组血糖指标、胰岛功能、有效性。结果 联合组和单一组用药前空腹血糖、餐后2 h血糖、糖化血红蛋白,差异无统计学意义(P>0.05)。用药后,联合组空腹血糖、餐后2 h血糖、糖化血红蛋白均降低,且比单一组低,差异有统计学意义(P<0.05)。联合组和单一组用药前空腹胰岛素、胰岛素抵抗指数,差异无统计学意义(P>0.05)。用药后,联合组空腹胰岛素、胰岛素抵抗指数比单一组低,差异有统计学意义(P<0.05)。联合组治疗有效率为97.18%,高于单一组(85.92%),差异有统计学意义(P<0.05)。结论 长效胰岛素+降糖药能达到较高的有效性,可控制血糖,纠正胰岛素功能。  相似文献   

11.
目的探讨甘精胰岛素与口服降糖药联用控制空腹及餐后高血糖的疗效。方法将136例单用口服降糖药血糖控制不理想的T2DM患者随机分为A、B两组。A组采用国产甘精胰岛素(长秀霖),B组采用进口甘精胰岛素(来得时),两组在用甘精胰岛素的基础上,均分别与二甲双胍和瑞格列奈联用,观察治疗前后FPG、2hPG及HbA1C水平和低血糖的发生率。结果治疗后两周时FPG、2hPG及HbA1C水平与治疗前相比均明显下降,但仍未达标。两组患者在甘精胰岛素和二甲双胍治疗的基础上加用瑞格列奈,治疗后4周时FPG及2hPG水平均已达标,HbA1C水平于治疗2个月时达标。两组治疗后各项指标与治疗前相比均明显下降(P均〈0.01),两组临床疗效无统计学差异,低血糖发生率分别为4.2%和4.6%,相比无统计学差异(P〉0.05)。结论两种甘精胰岛素分别与二甲双胍和瑞格列奈联用,能较好控制FPG、2hPG及HbA1C水平,低血糖发生率均较低,临床疗效相近。因此,甘精胰岛素与二甲双胍和瑞格列奈联用是控制FPG、2hPG及HbA1C水平的安全有效的治疗方案。  相似文献   

12.
The objective was to compare the impact on treatment satisfaction (TS) and quality of life (QoL) of early insulinization with glargine versus adjusting oral antidiabetic drug (OAD) therapy in people with Type 2 diabetes with uncontrolled glycemia. TS and QoL were assessed at baseline, weeks 12 and 24 within the Canadian INSIGHT, a randomized 24-week trial of Type 2 patients. A total of 366 patients randomized to either the insulin glargine arm (n=182) or the adjusted OAD therapy arm (n=184) completed both questionnaires. At baseline, TS and QoL were similar in both groups. A1c reduction was greater in the insulin glargine arm. TS improved from baseline in both treatment arms; however, there was greater increase with insulin glargine+OAD. Perceived frequency of hypoglycemia and hypoglycemia were lower at week 24, with no differences between the two groups. Perceived frequency of hyperglycemia improved with glargine at week 12, and no difference was found at 24 weeks. Finally, QoL improved in both groups, but significantly more with glargine at both weeks 12 and 24. Improving glucose control by adding insulin glargine to OAD therapy had a positive impact on TS and general QoL without complaints related to hypoglycemia.  相似文献   

13.
Glycemic control in elderly persons with type 2 diabetes mellitus (T2DM) is challenging because they are more likely to have other age-associated medical conditions and to experience hypoglycemia during intensive therapy. A best therapeutic strategy for these patients has not yet been defined. We investigated the efficacy and safety of adding once-daily insulin glargine to patients’ current oral antidiabetic drugs (OAD) regimen, compared to increasing the OAD doses. The study enrolled patients aged 65 years or more, with poor glycemic control. Patients were randomized to two groups and entered a 3-week titration period in which their actual therapy was adjusted to meet the study’s glycemic goals, by either adding insulin glargine to current therapy (group A, 27 patients) or increasing current OAD dosages (group B, 28 patients). Thereafter, therapies were continued unchanged for a 24-week observation period. The mean therapeutic dosage of insulin glargine in group A was 14.9 IU/day (SD = 5.0 IU/day). During the observation period, mean levels of glycosylated hemoglobin (HbA1c) reduced by 1.5% in group A and 0.6% in group B (P = 0.381). An HbA1c level <7.0% was achieved by five patients in each group. Mean fasting blood glucose levels reduced by 29 and 15% in groups A and B, respectively (P = 0.029). Group A had fewer total hypoglycemic events (23 vs. 79, P = 0.030) and fewer patients experiencing any such event (9 vs. 17, P = 0.045). Neither a serious hypoglycemic event nor other adverse event occurred. These results suggest that, compared to increasing OAD dosage, the addition of insulin glargine to current OAD therapy is as effective but safer in terms of the risk for hypoglycemia in elderly patients with T2DM.  相似文献   

14.
OBJECTIVES: To compare initiation of insulin therapy by adding once-daily insulin glargine to oral antidiabetic agents (OADs) with switching patients to premixed 30% regular, 70% human neutral protamine hagedorn insulin (70/30) without OADs. DESIGN: A 24-week, multicenter, open, randomized (1:1), parallel study. SETTING: Three hundred sixty-four poorly controlled patients with type 2 diabetes mellitus were treated with once-daily morning insulin glargine with continued OADs (glimepiride+metformin) (glargine+OAD) or twice-daily 70/30 alone. Insulin dosage in each group was titrated to target fasting blood glucose (FBG) of 100 mg/dL or less (or=6.7 mmol/L) and hemoglobin (Hb)A(1c) levels between 7.5% and 10.5% on OADs (glargine+OAD, n=67; 70/30, n=63). MEASUREMENTS: HbA(1c), FBG, hypoglycemia, insulin dose, and adverse events were recorded. RESULTS: HbA(1c) decreased from baseline to endpoint for both glargine+OAD (from 8.8% to 7.0%) and 70/30 (from 8.9% to 7.4%); adjusted mean HbA(1c) decrease for glargine+OAD and 70/30 was -1.9% and -1.4%, respectively (P=.003). More patients reached HbA(1c) of 7.0% or less without confirmed nocturnal hypoglycemia with glargine+OAD (n=37, 55.2%) than with 70/30 (n=19, 30.2%) (P=.006). FBG decreased significantly more with glargine+OAD (-57 mg/dL (-3.2 mmol/L)) than with 70/30 (-40 mg/dL (-2.2 mmol/L)) (P=.002). Patients treated with glargine+OAD experienced fewer episodes of any hypoglycemia (3.68/patient-year) than did those treated with 70/30 (9.09/patient-year) (P=.008). CONCLUSION: In elderly patients, addition of once-daily morning glargine+OAD is a simple regimen to initiate insulin therapy, restoring glycemic control more effectively and with less hypoglycemia than twice-daily 70/30 alone.  相似文献   

15.
动态血糖监测甘精胰岛素治疗老年2型糖尿病的研究   总被引:2,自引:0,他引:2  
目的通过动态血糖监测(CGMS),评估甘精胰岛素治疗老年2型糖尿病(T2DM)的疗效和安全性。方法对39例口服药联合治疗空腹血糖控制不佳的老年T2DM患者,加用甘精胰岛素(IG)和中性鱼精蛋白锌胰岛素(NPH)睡前皮下注射,治疗12周。治疗前后测定空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbAlc)、空腹C肽及餐后2hC肽等,并进行比较。结果治疗后,2组血糖和HbAlc均较治疗前下降(P〈0.05或P〈0.01),IG组血糖下降更明显(P〈0.05),2组HbAlc无明显差异(P〉0.05),IG组治疗后餐后2hC肽水平提高(P〈0.05)。CGMS显示IG组24h血糖曲线平缓,血糖达标时间延长,夜间低血糖的发生率低(P〈0.01).血糖波动幅度小。结论IG作为老年T2DM患者的基础胰岛素替代治疗,血糖控制达标率高,胰岛素剂量控制更方便、安全,优于NPH。  相似文献   

16.
Objective: For many patients with type 2 diabetes, oral antidiabetic agents (OADs) do not provide optimal glycaemic control, necessitating insulin therapy. Fear of hypoglycaemia is a major barrier to initiating insulin therapy. The AT.LANTUS study investigated optimal methods to initiate and maintain insulin glargine (LANTUS®, glargine, Sanofi-aventis, Paris, France) therapy using two treatment algorithms. This subgroup analysis investigated the initiation of once-daily glargine therapy in patients suboptimally controlled on multiple OADs. Research Design and Methods: This study was a 24-week, multinational (59 countries), multicenter (611), randomized study. Algorithm 1 was a clinic-driven titration and algorithm 2 was a patient-driven titration. Titration was based on target fasting blood glucose ≤100 mg/dl (≤5.5 mmol/l). Algorithms were compared for incidence of severe hypoglycaemia [requiring assistance and blood glucose <50 mg/dl (<2.8 mmol/l)] and baseline to end-point change in haemoglobin A1c (HbA1c). Results: Of the 4961 patients enrolled in the study, 865 were included in this subgroup analysis: 340 received glargine plus 1 OAD and 525 received glargine plus >1 OAD. Incidence of severe hypoglycaemia was <1%. HbA1c decreased significantly between baseline and end-point for patients receiving glargine plus 1 OAD (−1.4%, p < 0.001; algorithm 1 −1.3% vs. algorithm 2 −1.5%; p = 0.03) and glargine plus >1 OAD (−1.7%, p < 0.001; algorithm 1 −1.5% vs. algorithm 2 −1.8%; p = 0.001). Conclusions: This study shows that initiation of once-daily glargine with OADs results in significant reduction of HbA1c with a low risk of hypoglycaemia. The greater reduction in HbA1c was seen in patients randomized to the patient-driven algorithm (algorithm 2) on 1 or >1 OAD.  相似文献   

17.
BACKGROUND: Addition of the long-acting basal human insulin analogue insulin glargine (LANTUS) to the treatment regimen of patients with inadequate glycaemic control on oral antidiabetic drugs (OADs) alone has previously been evaluated as effective, safe and convenient. This pilot study aimed to establish whether insulin glargine plus OADs is effective in Type 2 diabetes patients previously poorly controlled on premixed insulin therapy. METHODS: In an open, controlled, randomized, parallel-group, single-centre, 16-week pilot study, 52 patients (age 65.6+/-9.2 years; diabetes duration 15.3+/-7.6 years; insulin therapy duration 4.2+/-1.7 years, body mass index 31.4+/-2.9 kg/m2) with Type 2 diabetes (HbA1c>or=8.0%) on premixed human insulin (75/25 or 70/30) were randomized to once-daily morning insulin glargine plus glimepiride (Group A; n=17), insulin glargine plus glimepiride and metformin (Group B; n=18) or premixed insulin (Group C; n=17). Glycaemic control and incidence of hypoglycaemia were evaluated. RESULTS: HbA1c decreased significantly from baseline in Groups A and B, but not in Group C; (Group A: 7.87+/-0.66%, -0.35%, p=0.013; Group B: 7.44+/-0.92%, -0.69%, p=0.0057; Group C: 7.83+/-1.13%, -0.25%, p=0.32). There were no between-treatment differences at endpoint in HbA1c, fasting blood glucose, mean daily blood glucose or symptomatic hypoglycaemia (mean events/patient: Group A, 2.2; Group B, 2.3; Group C, 2.0). At endpoint, 88% of patients in Group A, 81% in Group B and 94% in Group C opted to continue with their assigned regimen. CONCLUSIONS: This pilot study is the first prospective study to show that switching from premixed insulin to insulin glargine plus OAD treatment resulted in similar glycaemic control and treatment satisfaction. The results support the need for prospective examination in a larger-scale clinical study in patients with long-standing Type 2 diabetes and sub-optimal glycaemic control previously using a conventional premixed insulin regimen.  相似文献   

18.
BACKGROUND: Addition of the long-acting basal human insulin analogue insulin glargine (LANTUS) to the treatment regimen of patients with inadequate glycaemic control on oral antidiabetic drugs (OADs) alone has previously been evaluated as effective, safe and convenient. This pilot study aimed to establish whether insulin glargine plus OADs is effective in Type 2 diabetes patients previously poorly controlled on premixed insulin therapy. METHODS: In an open, controlled, randomized, parallel-group, single-centre, 16-week pilot study, 52 patients (age 65.6+/-9.2 years; diabetes duration 15.3+/-7.6 years; insulin therapy duration 4.2+/-1.7 years, body mass index 31.4+/-2.9 kg/m(2)) with Type 2 diabetes (HbA (1c)> or =8.0%) on premixed human insulin (75/25 or 70/30) were randomized to once-daily morning insulin glargine plus glimepiride (Group A; n=17), insulin glargine plus glimepiride and metformin (Group B; n=18) or premixed insulin (Group C; n=17). Glycaemic control and incidence of hypoglycaemia were evaluated. RESULTS: HbA (1c) decreased significantly from baseline in Groups A and B, but not in Group C; (Group A: 7.87+/-0.66%, -0.35%, p=0.013; Group B: 7.44+/-0.92%, -0.69%, p=0.0057; Group C: 7.83+/-1.13%, -0.25%, p=0.32). There were no between-treatment differences at endpoint in HbA (1c), fasting blood glucose, mean daily blood glucose or symptomatic hypoglycaemia (mean events/patient: Group A, 2.2; Group B, 2.3; Group C, 2.0). At endpoint, 88% of patients in Group A, 81% in Group B and 94% in Group C opted to continue with their assigned regimen. CONCLUSIONS: This pilot study is the first prospective study to show that switching from premixed insulin to insulin glargine plus OAD treatment resulted in similar glycaemic control and treatment satisfaction. The results support the need for prospective examination in a larger-scale clinical study in patients with long-standing Type 2 diabetes and sub-optimal glycaemic control previously using a conventional premixed insulin regimen.  相似文献   

19.
目的评价甘精胰岛素和预混胰岛素在老年T2DM治疗中的优越性。方法68例老年T2DM患者随机分为甘精胰岛素组(Gla组)和预混胰岛素组(Pre组),比较两组治疗前后FBG、2hBG、HbA1c、空腹C肽(FC-P)及75g OGTT后2hC肽(2hC-P)水平、体重变化、低血糖发生率及患者满意度。结果治疗后两组FBG、2hBG、HbA1c水平均较治疗前显著降低(P〈0.01),Gla组FBG、HbA1c水平较Pre组显著降低(P〈0.05),Pre组2hC-P水平较治疗前显著增加(P〈0.05)。Gla组体重增加、低血糖发生率显著低于Pre组(P〈0.05或P〈0.01)。结论老年T2DM患者应用甘精胰岛素是有益的治疗方案。  相似文献   

20.
目的 了解江苏省单用口服降糖药物(OAD)的T2DM患者的用药情况和血糖控制状况。 方法 选取江苏省13个城市各级医院门诊T2DM患者2966例进行横断面研究,以问卷形式收集患者个人信息、病程资料、治疗及合并症情况,检测HbA1c。 结果 单用OAD患者1524例,平均HbA1c(7.0±1.5)%。高脂血症患病率56.2%,高血压患病率41.4%。63.6%患者HbA1c达标(HbA1c〈7.0%)。20-40岁组HbA1c达标率高于41-60、61-80岁组(P〈0.05)。病程≤5年组HbA1c达标率高于5-10、〉10年组(P〈0.05)。双胍类药物在OAD中所占比例最高,且在各级医院所占比例亦最高。 结论 2009年单用OAD患者的HbA1c达标率高于2010年全国达标率,年轻及短病程患者改善尤为明显。双胍类药物在OAD中使用仍占首位。  相似文献   

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