长效胰岛素联合口服降糖药治疗2型糖尿病的疗效与安全性分析

目的观察临床上针对2型糖尿病的患者,使用长效胰岛素(注射)、降糖药(口服)联合的方法治疗的效果和安全性。方法 2015年2月—2016年12月间选取该院2型糖尿病患者84例,将其分段随机化分2组,42例为一组。一组给予口服降糖药(对照组),另一组再使用长效胰岛素(观察组),对比2组各项血糖指标和发生的不良反应情况。结果观察组2型糖尿病患者的3项血糖数据较为平稳,不良反应数据是4.76%,优于对照组的各项情况(P0.05)。结论注射长效胰岛素和口服降糖药2者联合治疗2型糖尿病的患者,对于改善其血糖指标效果显著,且能够保证临床上较高的安全系数(不良反应发生概率较低)。     

磺脲类降糖药继发失效的2型糖尿病用药分析

目的分析磺脲类降糖药继发失效的2型糖尿病应用不同药物治疗的效果,从而提高临床用药合理性。方法选取该院2016年1月—2017年7月收治的80例磺脲类降糖药继发失效的2型糖尿病患者,分为研究组和对照组,各40例。对照组在磺脲类降糖基础上,采用二甲双胍治疗,研究组联合应用瑞格列奈与二甲双胍治疗,观察两组治疗效果。结果研究组治疗有效率为95.0%,对照组有效率为75.0%,差异有统计学意义(P0.05)。研究组不良反应发生率为7.5%,与对照组的12.5%比较差异无统计学意义(P0.05)。结论磺脲类降糖药继发失效的2型糖尿病应用瑞格列奈与二甲双胍联合治疗,具有较好疗效,有助于减少患者不良反应发生,提高其生活质量。     

口服降糖药联合甘精胰岛素及餐前一次门冬胰岛素的治疗达标研究——1+1研究

目的 观察2型糖尿病患者经口服降糖药联合甘精胰岛素治疗仍未达标时,于餐前增加1次门冬胰岛素的有效性、安全性和可行性.方法 采用多中心、开放、自身对照的方法.59例经口服降糖药及甘精胰岛素治疗而糖化血红蛋白(Hb)A1c＞6.5%但＜9%的患者,于主餐前加用门冬胰岛素治疗16周.结果 16周后,患者HbA1c由治疗前的(...     

我院2型糖尿病高血压住院患者降糖药利用分析

目的 分析我院2型糖尿病高血压住院患者降糖药利用情况.方法 对江西省九江市第一人民医院2009年第一季度82例2型糖尿病高血压住院患者应用降糖药品种、数量、人均用药时间、合理用药情况等进行回顾性、DUR、DUE等分析.结果 19种药物有5种药品的DUI＜1,6种药品的DUI＞1,8种药品的DUI=1;降糖药中注射用胰岛素和口服降糖药中双胍类使用最多;58.5％的患者使用了两种或两种以上的降糖药.结论 我院2型糖尿病高血压住院患者使用降糖药基本合理.     

A clinical use of insulin detemir in type 2 diabetes

目的 观察口服降糖药血糖控制不佳的2型糖尿病患者,分别加用地特胰岛素(Det)或中性鱼精蛋白锌胰岛素(NPH)治疗的有效性、安全性及对体重的影响.方法 将84例口服降糖药血糖控制不佳的2型糖尿病患者随机分为两组,分别睡前加用Det和NPH,治疗16周.结果 治疗16周后,两组患者空腹血糖和糖化血红蛋白均较基线下降(P＜0.01),但两组间比较差异无统计学意义(P＞0.05);Det组低血糖发生率为2.4％,较NPH组的9.5％更低,Det组体重增加明显低于NPH组(P＜0.01).结论 对于口服降糖药血糖控制不佳的2型糖尿病患者,加用Det与加用NPH相比,有效性相似,但体重增加少,低血糖发生率低,安全性更高.     

分析磺脲类降糖药继发失效的2型糖尿病用药治疗效果

目的探讨针对磺脲类降糖药继发失效2型糖尿病患者,观察选择参芪降糖颗粒+二甲双胍完成治疗后的临床效果。方法选取该院2012年10月—2014年10月磺脲类降糖药继发失效2型糖尿病患者100例。针对所有患者选择参芪降糖颗粒+二甲双胍的方法进行治疗。观察糖尿病患者完成治疗后获得的临床疗效以及不良反应表现。结果所有2型糖尿病患者完成治疗后,显效患者85例(85.00%);有效患者13例(13.00%);无效患者2例(2.00%),临床治疗总有效率为98.00%;共2例患者表现出恶心头痛症状,经过对应处理后,全部有效缓解。结论针对磺脲类降糖药继发失效2型糖尿病患者,临床选择参芪降糖颗粒+二甲双胍进行疾病治疗,能够有效避免糖尿病患者出现严重不良反应,提高临床治疗效果,最终显著提高2型糖尿病患者的生活质量。     

长效胰岛素联合口服降糖药治疗2型糖尿病的疗效研究

目的就长效胰岛素联合口服降糖药使用于2型糖尿病的临床疗效展开分析探究。方法选取2014年1月—2015年1月时间段该院接收的100例2型糖尿病患者,将他们划分成为研究组与对照组,各50例,对照组单纯采取降糖药治疗,研究组基于对照组采取长效胰岛素联合治疗,就两个组别患者临床治疗效果进行比较分析。结果研究组FBG(4.9±0.5)mmol/L、2h PBG(7.9±2.1)mmol/L及Hb A1c(5.9±1.0)%相较于对照组(8.1±0.9)mmol/L、(12.8±2.7)mmol/L及(8.7±1.6)%更低,数据对比差异有统计学意义(P0.05);研究组血糖控制率94.0%相较于对照组76.0%明显更高,数据对比差异有统计学意义(P0.05)。结论长效胰岛素联合口服降糖药使用于2型糖尿病患者临床疗效理想,可明显促进患者机体血糖得到调节,提升血糖控制率,具备推广借鉴价值。     

一种口服降糖药不能控制血糖达标后降糖药物的选择

2型糖尿病在全球许多地区的发病率快速增长,目前,中国2型糖尿病患者达3400万.尽管有充分的证据表明,血糖控制不佳和微血管及大血管并发症相关,临床上也有多种口服降糖药和各种胰岛素剂型,但是我国2003年调查表明,糖化血红蛋白(HbA,c)>6.5%的2型糖尿病患者比例仍然高达74%[1].     

长效胰岛素联合口服降糖药治疗2型糖尿病的疗效探讨

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。     

甘精胰岛素联合口服降糖药治疗2型糖尿病疗效观察

目的探究2型糖尿病患者通过甘精胰岛素与口服降糖药联合治疗后所存在的应用价值。方法选取该院收治的2型糖尿病患者80例,且均在2015年1月—2017年1月入院,依随机分组标准分为观察组(40例)和对照组(40例)。对照组和观察组患者治疗方法分别为口服降糖药物治疗和甘精胰岛素与口服降糖药联合治疗。从血糖水平、糖化血红蛋白值、体重指数、不良反应发生及生存质量状况入手,针对相关内容进行分析。结果对照组的空腹血糖以及饭后2 h的血糖高于观察组,差异有统计学意义(P0.05);观察组糖化血红蛋白值及体重指数均低于对照组(P0.05);对照组的不良反应发生率(5.00%)与观察组(7.50%)比较差异无统计学意义(P0.05);对照组在生存质量方面的指标小于观察组,差异有统计学意义(P0.05)。结论 2型糖尿病患者通过甘精胰岛素与口服降糖药联合治疗后,可以同时改善患者的生存质量以及血糖水平,降低糖化血红蛋白的水平以及体重指数,降低不良反应的发生率。     

Starting insulin therapy in type 2 diabetes: twice-daily biphasic insulin Aspart 30 plus metformin versus once-daily insulin glargine plus glimepiride.

AIM: To compare the efficacy and safety of two analog insulins as starting regimens in insulin-na?ve Type 2 diabetes patients. METHODS: In this randomized, open-label parallel study, twice-daily biphasic insulin aspart 30 (30% soluble and 70% protaminated insulin aspart; BIAsp 30) plus metformin (met) was compared with once-daily insulin glargine (glarg) plus glimepiride (glim) in 255 insulin-na?ve patients (131 male; mean+/-SD age, 61.2+/-9.1 years). Mean baseline HbA (1c) (+/-SD) was 9.2+/-1.4% and 8.9+/-1.3% for BIAsp 30 plus met ( N=128) and glarg plus glim ( N=127), respectively ( P=0.0747). Primary endpoint was the difference in absolute change in HbA (1c) between groups after 26 weeks of treatment. RESULTS: HbA (1c) change was significantly greater in the BIAsp 30 plus met group than the glarg plus glim group (between-group difference: -0.5% (95% CI: -0.8; -0.2); P=0.0002). Mean prandial plasma glucose increment was significantly lower for BIAsp 30 plus met compared with glarg plus glim: 1.4+/-1.4 mmol/l vs. 2.2+/-1.8 mmol/l; P=0.0002. During the maintenance phase (weeks 6-26), one major hypoglycemic episode occurred in each group; 20.3% and 9% of patients experienced minor hypoglycemic episodes in the BIAsp 30 plus met and glarg plus glim groups, respectively ( P=0.0124). At end-of-trial, mean daily insulin doses were 0.40 U/kg BIAsp 30 and 0.39 U/kg glarg. Glarg plus glim-treated patients experienced significant weight gain of 1.5 kg (95% CI: 0.84; 2.19; P<0.0001). Weight change with BIAsp 30 plus met of +0.7 kg was not statistically significant (95% CI: -0.07; 1.42; P=0.0762). CONCLUSIONS: Starting insulin in Type 2 diabetes patients with twice-daily BIAsp 30 plus met can reduce HbA (1c) and mean prandial plasma glucose increment to a greater extent than once-daily glarg plus glim.     

双时相门冬胰岛素30联合二甲双胍治疗基础胰岛素控制不佳的2型糖尿病患者:疗效及安全性评价

目的 评价既往基础胰岛素联合口服降糖药物(OAD)治疗血糖控制不佳的2型糖尿病患者转用双时相门冬胰岛素30(BIAsp30)联合二甲双胍治疗的疗效及安全性.方法 本试验为多中心、非随机、开放、单组治疗达标研究,包括2周筛选期、4周导入期和16周治疗期.既往使用基础胰岛素联合OAD治疗血糖控制不佳的2型糖尿病患者转用每日两次BIAsp30注射联合口服二甲双胍治疗.收集疗效及安全性数据进行统计学分析.结果 共293例患者(男154,女139)入选,平均年龄(54.0±9.6)岁,平均糖尿病病程(8.54±5.49)年,平均体重指数(24.89±3.28)kg/m2,HbA1c 8.16%±0.89%,122例既往使用基础胰岛素类似物,169例使用人中效胰岛素.经16周的治疗,平均HbA1C降幅达1.30%±0.96%(P＜0.01);HbA1C达到＜7.0%和≤6.5%的患者比例分别为60.4%和38.9%.患者8点血糖谱各点血糖值均有显著降低(P＜0.01),8点血糖均值由基线时的(10.53±2.58)mmol/L降至(7.79±1.58)mmol/L(P＜0.01),降幅为2.76 mmol/L.早餐和晚餐后血糖增幅显著下降,分别下降了1.73 mmol/L(P＜0.01)和1.28 mmol/L(P＜0.01),而午餐后的血糖增幅未发现显著性降低(-0.09 mmol/L,P=0.734 5).研究治疗中无严重不良事件和重度低血糖事件报告,总体低血糖发生率为2.68例/患者年;患者体重平均增加(0.76±0.14)kg(P＜0.01).结论 BIAsp30联合二甲双胍可显著改善基础胰岛素联合OAD血糖控制不佳的2型糖尿病患者的血糖控制,并具有良好的安全性.     

Biphasic insulin aspart 30 plus metformin: an effective combination in type 2 diabetes

AIM: This study compared glycaemic control achieved with biphasic insulin aspart 30 (BIAsp 30) monotherapy, BIAsp 30 plus metformin and glibenclamide plus metformin in patients with type 2 diabetes not adequately controlled with metformin. METHODS: In this multinational, open-labelled, parallel group, 16-week trial, 341 patients (patients not adequately controlled with metformin for at least 1 month) with type 2 diabetes were studied. Patients were randomized to receive BIAsp 30, twice daily (n = 107 exposed to treatment), or BIAsp 30, twice daily, plus metformin (n = 108) or glibenclamide plus metformin (n = 114). The primary endpoint was HbA(1c) at end of trial; adverse events, hypoglycaemia episodes, blood lipids and weight were also monitored. RESULTS: In the total population (HbA(1c) 7.5-13.0% at screening), end-of-trial HbA(1c) levels were lower in patients receiving BIAsp 30 plus metformin compared with those receiving BIAsp 30 only [mean treatment difference (+/-s.e.m), 0.39 +/- 0.15%, p = 0.007]. In a subpopulation (HbA(1c) > or = 9.0% at baseline, n = 193), patients receiving BIAsp 30 plus metformin had significantly lower HbA(1c) levels at the end of the trial compared with those receiving glibenclamide plus metformin (treatment difference, 0.46 +/- 0.21%, p = 0.027). Mean body weight (+/-s.d) at the end of the trial was significantly lower in patients receiving glibenclamide plus metformin compared with those receiving BIAsp 30 only (84.3 +/- 13.3 kg vs. 88.9 +/- 16.9 kg, p < 0.001). No major hypoglycaemic episodes were recorded during the trial, and incidence rates for minor and symptoms-only hypoglycaemia were low and similar between treatment groups (0.03-0.04 events/patient/week). CONCLUSION: BIAsp 30 added to metformin could be an appropriate therapeutic option for achieving good glycaemic control, compared with the addition of a second oral agent, particularly where HbA(1c) > or = 9%.     

Long-term efficacy and safety of biphasic insulin aspart in patients with type 2 diabetes

BACKGROUND: In this study, we sought to compare the long-term safety and efficacy of biphasic insulin aspart 30 (BIAsp30) with that of biphasic human insulin 30 (BHI30) over a period of 24 months in patients with type 2 diabetes. METHODS: Patients with type 2 diabetes (n=125) were assigned to twice-daily BIAsp30 or BHI30 and participated in both a 3-month initial period and a 21-month extension of a randomized, controlled, multinational trial. RESULTS: No significant difference was found in mean HbA(1c) after 24 months [BIAsp30, 8.35+/-0.20%; BHI30 8.13+/-0.16%; adjusted mean difference (BIAsp30-BHI30) 0.03 (90% CI -0.29 to 0.34)%, P=0.89]. The proportion of patients experiencing major hypoglycaemia was also similar during the first year (BIAsp30, 5%; BHI30, 8%; P=0.72), but it was significantly lower with BIAsp30 than with BHI30 during the second year (BIAsp30, 0%; BHI30, 10%; P=0.04). The proportion experiencing minor hypoglycaemia was not significantly different. No significant difference was recorded in changes in nonspecific insulin antibody levels after 24 months (BIAsp30, 4.87+/-1.92%; BHI30; 1.00+/-1.66%; P=0.13). Body weight change was 0.05+/-0.81 kg in the BIAsp30 group and 2.00+/-0.69 kg in the BHI30 group (P=0.07). CONCLUSIONS: Reduced major hypoglycaemia compared with BHI30 during the second year of treatment and comparable HbA(1c) levels after 24 months appear to support the hypothesis that the improved pharmacokinetic profile of BIAsp30 may favourably affect the balance between hypoglycaemia and hyperglycaemia in insulin-treated type 2 diabetes.     

Attainment of glycaemic goals in type 2 diabetes with once-, twice-, or thrice-daily dosing with biphasic insulin aspart 70/30 (The 1-2-3 study)

AIM: This observational study in patients with type 2 diabetes failing oral agent therapy with or without basal insulin was conducted to assess whether addition and self-titration of biphasic insulin aspart 70/30 (BIAsp 30) could achieve American Association of Clinical Endocrinologists (AACE)/International Diabetes Federation (IDF) and American Diabetes Association (ADA) glycemic targets (HbA(1c)< or =6.5 and <7%). METHODS: Enrolled patients (n = 100, HbA(1c)> or =7.5 and < or =10%) were > or =18 years of age, had diabetes > or =12 months and had received a stable antidiabetic regimen for at least 3 months [minimum of two oral antidiabetic drugs (OADs) or at least one OAD plus once-daily basal insulin < or =60 U]. Patients discontinued prior basal insulin and added one injection of BIAsp 30 (12 U or 70-100% of prior basal insulin dose within 15 min of dinner initiation). Patients self-titrated their BIAsp 30 dose with investigator guidance every 3 or 4 days to achieve pre-breakfast fasting blood glucose (FBG) of 80-110 mg/dl. At 16 weeks, a pre-breakfast injection of 6 U of BIAsp 30 was added if week 15 HbA(1c) exceeded 6.5%; the added dose was titrated to achieve pre-dinner BG of 80-110 mg/dl. After an additional 16 weeks, 3 U of pre-lunch BIAsp 30 was added if HbA(1c) exceeded 6.5%. This added dose was adjusted based on 2-h post-lunch BG to achieve postprandial glucose of 100-140 mg/dl. Subjects achieving an HbA(1c)< or =6.5% at 15 and 31 weeks completed the study at weeks 16 and 32 respectively. RESULTS: Addition of once-daily BIAsp 30 before dinner enabled 21% of the patients to achieve AACE and IDF targets (HbA(1c)< or =6.5%) and 41% to achieve ADA targets (HbA(1c) <7%). With two daily injections of BIAsp 30, these glycaemic goals were achieved by 52 and 70% of subjects. With three daily BIAsp 30 injections, 60% of patients achieved HbA(1c)< or =6.5%, and 77% achieved HbA(1c) <7.0%. CONCLUSIONS: This clinical trial demonstrates that initiation of once-daily BIAsp 30 to type 2 diabetes patients poorly controlled on various OAD regimens was an effective treatment approach for achieving glycaemic goals. Additional patients safely achieved these goals by increasing the number of BIAsp 30 injections from one to two, and then, if uncontrolled, from two to three doses per day. Eventually, most patients previously uncontrolled on OADs with or without basal insulin were controlled by the addition and vigorous titration of BIAsp 30 to oral agent therapy.     

每日1次双时相门冬胰岛素30与甘精胰岛素治疗2型糖尿病患者的比较——Easymix研究中国亚组结果

目的 观察比较对于口服降糖药治疗效果不佳的中国T2DM患者,每日1次双时相门冬胰岛素30（BIAsp30）与甘精胰岛素的有效性及安全性. 方法 采用开放、随机、多中心的平行对照法,纳入口服降糖药治疗效果不佳且未长期使用胰岛素的T2DM患者,随机接受每日晚餐前1次BIAsp30或每日睡前1次甘精胰岛素,联合二甲双胍及格列美脲治疗24周后评价有效性及安全性. 结果 BIAsp30组210例,甘精胰岛素组212例.治疗结束时,BIAsp30组和甘精胰岛素组HbA1c分别较基线值下降-0.75％和-0.66％（BIAsp30组一甘精胰岛素组=0.08％,95％ CI：-0.23～0.07）.BIAsp30组晚餐后和睡前血糖水平低于甘精胰岛素组（P＜0.01）,而晚餐前血糖水平则高于甘精胰岛素组（P＜0.01）.BIAsp30组餐后血糖增量均值变化及晚餐后血糖增量的变化优于甘精胰岛素组.两组间低血糖事件和不良反应发生情况差异无统计学意义. 结论 以HbA1c作为有效性指标,每日注射1次BI-Asp30作为中国T2DM患者的胰岛素起始方案不劣于每日注射1次甘精胰岛素,且不增加低血糖事件及发生不良反应的风险.     

艾塞那肽及门冬胰岛素30注射液对不同基线特征糖尿病患者血管功能状态的影响

目的:比较艾塞那肽和门冬胰岛素30注射液对不同基线特征2型糖尿病（T2DM）患者颈动脉内膜中层厚度（cIMT）的影响,探讨艾塞那肽改善动脉粥样硬化（AS）的影响因素。方法:选取2015年3月10日至2017年6月20日于北京医院内分泌科门诊就诊的T2DM患者为研究对象,共纳入资料齐全符合入选条件的患者59例。研究设计为...     

Exenatide compared with long-acting insulin to achieve glycaemic control with minimal weight gain in patients with type 2 diabetes: results of the Helping Evaluate Exenatide in patients with diabetes compared with Long-Acting insulin (HEELA) study

Aim: The Helping Evaluate Exenatide in overweight patients with diabetes compared with Long-Acting insulin (HEELA) study was designed to examine whether the glucagon-like peptide-1 (GLP-1) receptor agonist, exenatide, could improve HbA1c (≤7.4%) with minimal weight gain (≤1 kg) compared with insulin glargine.
Methods: Patients [body mass index (BMI) >27 kg/m²] with elevated cardiovascular risk and type 2 diabetes inadequately controlled on two or three oral antidiabetes drugs (OADs) were randomized to add-on exenatide 5–10 μg b.i.d. (n = 118) or insulin glargine o.d. (titrated to target fasting plasma glucose ≤5.6 mmol/l; n = 117) for 26 weeks.
Results: The study population had baseline mean (s.d.) age of 56.5 (9.1) years and BMI of 34.1 (5.3) kg/m², and 58.5% of patients were taking two OADs. Mean baseline HbA1c was 8.65 (0.68)% in the exenatide group and 8.48 (0.66)% in the insulin glargine group. The proportions of patients achieving the composite endpoint of HbA1c ≤7.4% with weight gain ≤1 kg were 53.4% for the exenatide group and 19.8% for the insulin glargine group (p < 0.001 for exenatide vs. insulin glargine). Exenatide and insulin glargine did not demonstrate a significant difference in HbA1c improvements [least square (LS) mean [s.e.m.]: −1.25 [0.09]% and −1.26 [0.09]% respectively; p = 0.924], but had divergent effects on body weight (−2.73 [0.31] vs. +2.98 [0.31] kg respectively, p < 0.001) after 26 weeks. There were more treatment-related adverse events with exenatide but a lower incidence of nocturnal hypoglycaemia, with no differences in overall or severe hypoglycaemia.
Conclusions: Additional treatment with exenatide resulted in significantly more overweight and obese patients with an elevated cardiovascular risk and type 2 diabetes achieving better glycaemic control with minimal weight gain compared with insulin glargine.     

利拉鲁肽和门冬胰岛素30对超重和肥胖2型糖尿病患者的疗效和安全性比较

目的比较人胰高糖素样肽-1（GLP-1）类似物利拉鲁肽和门冬胰岛素30与二甲双胍联合应用对超重和肥胖2型糖尿病患者的疗效和安全性。方法选取2012年3月1013至2012年6月2013住院的体质指数（BMI）〉25kg／m^2的2型糖尿病患者109例,按随机数字表法分为利拉鲁肽治疗组和门冬胰岛素30治疗组。其中利拉鲁肽治疗组52例,给予利拉鲁肽联合二甲双胍治疗,门冬胰岛素30治疗组57例,给予门冬胰岛素30联合二甲双胍治疗共24周,于用药前、用药4、12、24周后分别测定患者的空腹血糖（FPG）、餐后2h血糖（PPG）、糖化血红蛋白（HbAlc）、体重、腰围、血压、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、肝功能、肾功能、C反应蛋白（CRP）、24h尿微量白蛋白（UMA）,记录用药期间低血糖发生情况和其他不良反应。采用t检验和重复测量资料方差分析进行数据分析。结果两组患者治疗3d后血糖均开始下降,24周后利拉鲁肽组和门冬胰岛素30组FPG分别下降（2．9±1．3）、（3．5±1．2）mmol／L（t=-3．2,P〈0．01）;PPG分别下降（4．2±3．7）、（4．5±2．8）mmol／L（t=-0．83,P〉0．05）;HbAlC分别下降（1．7±0．6）％、（1．9±0．8）％（t=-0．6,P〉0．05）。利拉鲁肽组体重下降（4．2±2．7）kg,门冬胰岛素30组体重增加（1．2±1．7）kg（t=-3．7,P〈0．05）。两组收缩压分别下降（5．2±4．4）、（1．8±2．3）mmHg（1mmHg=0．133kPa）（t=4．9,P〈0．01）。两组间舒张压差异无统计学意义。两组患者均出现TG、TC、LDL．C降低和HDL-C升高,但是组问差异均无统计学意义（均P〉0．05）。利拉鲁肽组比门冬胰岛素30组低血糖发生率低,但是两组间差异无统计学意义（3．8％比14．0％,t=-1．51,P〉0．05）。利拉鲁肽组患者的胃肠道不良反应多于门冬胰岛素30组,差异具有统计学意义（46．2％比1．8％,t=2．00,P〈0．05）。结论对超重和肥胖2型糖尿病患者,利拉鲁肽联合二甲双胍与门冬胰岛素30联合二甲双胍降糖效果相当,而利拉鲁肽能够更有效地降低患者体重和血压,同时具有良好的安全性。     

中国老年和中青年糖尿病患者使用双时相门冬胰岛素30的疗效及安全性：来自 A1 chieve 研究结果

目的：评价中国老年2型糖尿病（T2DM）患者使用双时相门冬胰岛素30（BIAsp30）的安全性及有效性,并与中青年患者研究结果进行比较。方法2008年11月至2011年3月从全国130家研究中心招募11020例T2DM患者进行前瞻性、多中心、开放、非干预的A1 chieve研究,为期24周。本文分析所有在研究中使用BIAsp30治疗的患者。研究对象分为老年组（年龄＞65岁）和中青年组（年龄≤65岁）,同时以研究前是否使用过胰岛素进行分组对比观察BIAsp30的疗效。各组糖化血红蛋白（ HbA1c）水平采用ANCOVA模型分析,低血糖事件采用McNemar′s配对比例检验分析。结果老年组1969例,中青年6508例接受BIAsp 30治疗。24周BIAsp30治疗期间无严重药物不良反应。老年组患者的总体夜间和重度低血糖事件分别从基线时的2.84、0.91和0.34次/患者年下降至2.00、0.41和0次/患者年,中青年组低血糖事件从基线时的2.19、0.48和0.10次/患者年,下降至1.39、0.23和0次/患者年。老年组和中青年组患者用药24周后HbA1c分别比基线时降低[治疗后（7.0±1.0）％和（7.0±1.0）％;基线（9.3±2.3）％和（9.6±2.3）％;老年t＝-33.47,P＜0.001;中青年t＝-67.94,P＜0.001];老年和中青年组患者HbA1c＜7.0％的达标率比基线增高[基线为13.8％（223/1620）和9.5％（514/5390）,治疗后为57.7％（682/1182）和55.0％（2124/3863）]。BIAsp 30治疗24周后,老年组和中青年组的空腹血糖均比基线降低[治疗后（6.8±1.2） mmol/L和（6.7±1.3） mmol/L;基线（9.8±3.5） mmol/L和（10.4±3.6） mmol/L,老年t＝-32.86,P＜0.001;中青年t＝-70.02,P＜0.001];早餐后2 h血糖分别比基线时下降[治疗后（8.9±1.7）和（8.8±1.8） mmol/L;基线（13.9±4.8）和（14.4±4.9） mmol/L,老年 t ＝-34.14, P ＜0.001;中青年t＝-67.70,P＜0.001]。老年组和中青年组患者的生活质量均有所改善。结论 BI