Comparison of HbA1c in Chinese patients with type 1 or type 2 diabetes randomized to twice daily insulin lispro low mix 25 or twice daily human insulin mix 30/70

Background Glycemic control prevents onset and progression of diabetes-related long-term complications. The objective of this study was to demonstrate that twice daily insulin lispro low mix 25 is noninferior to twice daily human insulin mix 30/70 in achieving glycemic control as measured by hemoglobin Alc （HbAlc）, from baseline to endpoint, in patients with type 1 or 2 diabetes. Methods In this phase IV, crossover, open-label, multicenter study, 117 Chinese patients with diabetes were randomly assigned to one of two treatment sequence groups. One group received 12-week treatment with twice daily human insulin mix 30/70 followed by 12-week treatment with twice daily insulin lispro low mix 25, while the other group received the reverse treatment sequence. HbAlc, baseline-to-endpoint change in HbAlc, proportion of patients achieving target HbAlc ≤ 7% and 〈 6.5%, fasting blood glucose, and daily insulin doses were measured for each period. Safety and tolerability were also assessed. Results A statistically significant reduction （P≤0.0001） of HbAlc was achieved after each treatment （human insulin mix 30/70： mean HbA1c=7.91% （95% CI： 7,67%, 8.15%）; insulin lispro low mix 25： mean HbA1c=7.96% （95% CI： 7.72%, 8.20%））. The 95% Cl （-0.20, 0.10） of the difference between the two treatments satisfied the prespecified noninferiority margin of 0.3% （lower limit of 95% CI 〉 -0.3%）. No statistically significant differences between treatments were observed for any of the secondary efficacy measures. The incidence of treatment-emergent adverse events and hypoglycemia between the two treatments and treatment sequence groups was similar. Three serious adverse events were reported （human insulin mix 30/70 group： 2 patients （1.7%, hypoglycemic coma and cardiac failure）; insulin lispro low mix 25 group： 1 patient （0.9%, stroke））. All serious adverse events were resolved and no patients died during the study. Conclusion The results support noninferiority of twice daily insulin lispro low mix 25 versus twice daily human insulin mix 30/70 in HbAlc control in Chinese patients with type 1 or 2 diabetes.     

预混胰岛素联合长效胰岛素与三速一长方案治疗初诊2型糖尿病的对比观察

目的观察早晚餐前预混胰岛素联合睡前长效胰岛素的注射方案(两预混一长)与三餐前速效胰岛素联合睡前长效胰岛素的注射方案(三速一长)对伴有明显高血糖的初诊2型糖尿病患者的降糖效果以及安全性。方法将60例初诊伴有明显高血糖的2型糖尿病患者随机分为I、Ⅱ两组,每组30例。I组三餐前皮下注射赖脯胰岛素联合睡前皮下注射甘精胰岛素;Ⅱ组早晚餐前皮下注射精蛋白锌重组赖脯胰岛素混合注射液25联合睡前皮下注射甘精胰岛素。比较空腹血糖、三餐后2小时血糖、胰岛素用量、达标时间以及低血糖发生人次。结果治疗后两组患者血糖、达标时间、低血糖发生率差异无统计学意义(>0.05),每日胰岛素用量Ⅱ组较I组明显减少(<0.05)。结论预混胰岛素联合长效胰岛素与三速一长方案治疗治疗效果、安全性相当,胰岛素用量减少。     

重组赖脯胰岛素与赖脯胰岛素治疗T2DM的疗效比较

目的：探讨重组赖脯胰岛素注射液与赖脯胰岛素注射液在2型糖尿病（T2DM ）治疗中的临床疗效和安全性。方法将血糖控制不佳的T2DM 患者48例按2∶1比例随机分为重组赖脯胰岛素组（观察组,n＝32）和赖脯胰岛素组（对照组,n＝16）,在睡前给予1次重组甘精胰岛素注射的基础上,三餐前分别给两组患者进行1次重组赖脯胰岛素或赖脯胰岛素注射,治疗周期16周。比较两组患者治疗前、后糖化血红蛋白（HbA1c）、空腹血糖（FPG ）、餐后2 h血糖（2hPG ）变化水平,并评估不良事件。结果44例完成研究,其中观察组28例,对照组16例。治疗16周后,两组患者 HbA1c、FPG和2hPG水平均明显降低（ P＜0．05）,观察组和对照组 HbA1c下降幅度分别为（1．55±1．50）％、（1．06±1．30）％,FPG下降幅度分别为（2．07±5．01）、（1．09±3．18）mmol／L ,2hPG下降幅度分别为（3．28±5．71）、（3．60±5．89）mmol／L。以 HbA1c为主要评价指标,0．40为非劣效界值,重组赖脯胰岛素注射液非劣效于赖脯胰岛素注射液（P＜0．05）。观察组 HbA1c≤6．50％的达标率为14．29％,HbA1c＜7．00％的达标率为28．57％;对照组 HbA1c≤6．50％的达标率为18．75％,HbA1c＜7．00％的达标率为43．75％,两组患者在 HbA1c两个水平达标率比较差异无统计学意义（P＞0．05）。结论重组赖脯胰岛素注射液治疗T2DM患者在有效性方面非劣效于赖脯胰岛素注射液,且具有相同的安全性。     

预混人胰岛素联合格列美脲治疗老年2型糖尿病疗效观察

目的对单用预混人胰岛素（30%短效与70%中效）血糖控制不佳的老年2型糖尿病患者联合应用格列美脲,观察其疗效及安全性。方法选取2006年1月至2008年3月符合纳入标准的共21名门诊就诊老年2型糖尿病患者,继续原有预混胰岛素治疗方案（均为每日早晚两次注射）,加用格列美脲2mg/d,门诊随访（加药后第1周第一次,以后每2周一次,至第13周）,采用t检验,对比分析基线及治疗后1周、13周后空腹及餐后血糖,基线及治疗13周后糖化血红蛋白（HbA1c）、尿微量白蛋白、胰岛素用量、肝功、肾功。结果 （1）加用格列美脲前患者平均空腹血糖（9.1±2.7）mmol/L,早餐后血糖（13.6±2.3）mmol/L,平均HbA1c（7.7±1.4）%;加药后13周平均空腹血糖（6.7±2.3）mmol/L,早餐后血糖（10.5±1.9）mmol/L,HbA1c（6.8±1.2）%,血糖、HbA1c明显下降,差异有统计学意义（P〈0.05）。（2）加用格列美脲前及加药后13周预混胰岛素用量分别为（53±4.5）U/d、（45±2.9）U/d,胰岛素用量下降,差异有统计学意义（P〈0.05）。结论每日两次注射预混人胰岛素联用格列美脲对老年2型糖尿病患者能改善血糖控制,安全性较好,方法简单,经济花费亦不高,依从性好,对符合条件的门诊老年2型糖尿病患者是一种较好的选择。     

双时相门冬胰岛素与预混人胰岛素治疗Ⅱ型糖尿病的疗效对比

目的比较双时相门冬胰岛素30（诺和锐30）和预混人胰岛素30R（诺和灵30R）治疗Ⅱ型糖尿病（T2DM）患者的有效性和安全性。方法将60例口服降糖药物血糖控制不佳的Ⅱ型糖尿病患者随机分为诺和锐30组和诺和灵30R组各30例,两组分别采用每日早晚餐前注射诺和锐30和早晚餐前30分钟注射诺和灵30R,治疗12周。观察两组患者空腹血糖（FBG）、餐后2 h血糖（2hPPG）、糖化血红蛋白（HbA1c）、血糖达标时间及低血糖发生率。结果两组治疗后FBG、2hPPG及HbA1c均明显降低（P〈0.01）。但诺和锐30组2hPPG、HbA1c控制好于诺和灵30R组（P〈0.05）;低血糖发生率低于诺和灵30R组（P〈0.05）。血糖达标时间短于诺和灵30R组（P〈0.05）,两组胰岛素用量差异无统计学意义（P〉0.05）。结论诺和锐30在疗效及安全性更优于诺和灵30R,也更易于为患者接受。     

Contribution of the Akt2 gene to type 2 diabetes in the Chinese Han population

Background  The Akt2 protein kinase is thought to be a key mediator of the insulin signal transduction process. Akt2 is suggested to play a role in glucose metabolism and the development or maintenance of proper adipose tissue and islet mass. In order to determine whether the Akt2 gene plays a role in the pathogenesis of type 2 diabetes characterized by insulin resistance, and to further identify if variations in this gene have a relationship with type 2 diabetes, we sequenced the entire coding region and splice junctions of Akt2 and made a further case-control study to explore the association between single-nucleotide polymorphisms (SNPs) in this gene and type 2 diabetes in the Chinese Han population.

Methods  We selected 23 probands with a type 2 diabetic pedigree whose family members’ average onset age was within 25 to 45 years old. The body mass index of all the participants was lower than 28 kg/m² and all of them were insulin-resistant (the fasting insulin level >100 pmol/L or 16 µIU/ml). The entire coding region and splice junctions of Akt2 were directly sequenced in these 23 probands. SNPs with a frequency of minor allele over 20 percent were selected to be further studied in a case-control study. We chose 743 non-diabetic subjects as the control group and 742 type 2 diabetic patients as the case group. All these subjects were genotyped. A Snapshot Technology Platform (Applied Biosystems) was used for genotyping.

Results  The Akt2 genes from all 23 subjects were successfully sequenced. We did not identify any mutation in the type 2 diabetic pedigree. Two SNPs were identified, 13010323T>C and 13007939G>T. 13010323T>C was in intron 9, which was the location of rs2304188 reported in Genbank. Its minor allele frequency was 13.04%. 13007939G>T was in the 3′-untranslated region (UTR) of exon 14, which was the location of rs2304186 reported in Genbank. Its minor allele frequency was 34.78%. The allele frequency of rs2304188 and rs2304186 were consistent with the frequency reported in Genbank. In the case-control study with 742 patients and 743 controls, there was no significant difference between the two groups for the allele frequency of rs2304186 (odd ratio: 0.96, 95% confidence interval: 0.82–1.12, P=0.597).

Conclusions  The Akt2 gene is not a major cause of diabetes in a non-obese Chinese Han population characterized by insulin resistance. There is no significant relationship between rs2304186 and type 2 diabetes in the Chinese Han population.

     

重组人胰岛素和人胰岛素类似物治疗2型糖尿病疗效对照

目的比较人胰岛素（诺和灵30R）与人胰岛素类似物（诺和锐30）治疗2型糖尿病的疗效。方法选取82例2型糖尿病患者,随机分成A组（诺和灵30R）41例,皮下注射诺和灵30R;B组（诺和锐30）41例,皮下注射诺和锐30,根据血糖水平调节胰岛素剂量,直至血糖满意达标。相关数据应用医学t检验。结果两组患者经人胰岛素治疗13周后,均能有效控制高血糖,两组间胰岛素平均剂量没有差异（P〉0．05）,但人胰岛素类似物组能更为理想达标,而且餐后2小时血糖控制更好,两组问比较有统计学差异（P〈0．05）。结论使用人胰岛素类似物较人胰岛素能更为有效的控制血糖,尤其是餐后血糖,有助于血糖长期达标。     

GLP-1 类似物利拉鲁肽联合门冬胰岛素30 对2 型糖尿病患者认知功能障碍的影响

目的 探究GLP-1 类似物利拉鲁肽联合门冬胰岛素30 治疗2 型糖尿病患者认知功能障碍的临床 疗效。方法 连续入选2014 年9 月-2016 年1 月山东省滕州市中心人民医院内住院的2 型糖尿病患者132 例, 将患者随机分成门冬胰岛素30 治疗组（对照组,66 例）和利拉鲁肽联合门冬胰岛素30 治疗组（实验组,66 例）,治疗1 年后随访结果,比较分析治疗前后两组患者血糖、血脂、体重指数及认知功能的变化情况。结果 治疗1 年后随访,实验组的血糖、体重指数较对照组改善,认知功能量表MMSE、MoCA、CMS 总分均高于 对照组（P <0.05）。结论 利拉鲁肽联合门冬胰岛素30 在控制血糖、降血脂、改善体重指数方面的临床疗效 优于单纯的门冬胰岛素30,且有效改善糖尿病患者认知功能。     

诺和锐30与诺和灵30R治疗2型糖尿病的临床观察

目的观察诺和锐30与诺和灵30R治疗2型糖尿病的临床效果。方法 72例2型糖尿病患者随机分为两组,分别注射诺和灵30R和诺和锐30特充,观察患者日胰岛素总量、FBG（空腹血糖）、PBG（餐后2h血糖）、HbA1c（糖化血红蛋白）及低血糖发生率。结果两组患者治疗12周后FBG、PBG及HbA1c均能明显降低血糖至正常范围,每日胰岛素用量以诺和灵组较诺和锐组为高,有显著性差异,而低血糖发生率两组比较无统计性差异。结论两组胰岛素治疗2型糖尿病均有很好的疗效,但诺和锐30R特充相对于诺和灵30R能更有效减少日胰岛素的用量,从而降低胰岛素引起的副作用,有更好的依从性。     

强化胰岛素治疗的2型糖尿病患者胰岛素脱离与否相关因素分析

目的比较强化胰岛素治疗的2型糖尿病患者在脱离胰岛素治疗和继续胰岛素治疗时的临床特点,分析脱离胰岛素的相关因素。方法统计66例入院的2型糖尿病患者的患病时间,检测开始胰岛素强化治疗、治疗过程、治疗结束时的糖化血红蛋白(HbA1 c)、体重指数(BM I)、胰岛素用量,观察脱离胰岛素所需时间。结果34例患者脱离胰岛素治疗,32例继续治疗,两组患者在年龄、治疗开始时间、BM I、HbA1 c差异均无统计学意义,而患病时间比较差异有统计学意义(P<0.05),脱离时的胰岛素用量和HbA1 c比继续治疗患者显著减低(P<0.01)。结论患病时间长短是胰岛素脱离与否的重要因素,胰岛素投入量及HbA1 c数值对脱离胰岛素与否有积极作用。     

甘精胰岛素联合阿卡波糖治疗2型糖尿病的疗效观察

目的：观察甘精胰岛素联合阿卡波糖治疗2型糖尿病的临床疗效。方法：将42例口服降糖药物控制不佳的2型糖尿病患者,随机分为对照组和治疗组各21例,对照组采用预混胰岛素（诺和灵30R）治疗,治疗组采用甘精胰岛素联合阿卡波糖治疗。治疗12周,观察治疗前后血糖达标情况、低血糖发生事件、体重指数及腰围变化。结果：两组患者的FBG、2hPG、HbA1C均较治疗前明显降低（P＜0.01）,两组治疗达标率对比无意义,治疗组达标率高于对照组,且低血糖发生率低（治疗组2人（9.5％）,对照组5人（23.8％）, P＜0.05）。结论：甘精胰岛素联合阿卡波糖治疗2型糖尿病可显著改善胰岛β功能、降低血糖,低血糖发生率低,临床效果显著,是一种较为理想联合治疗方法。     

利格列汀联合赖脯胰岛素50对初诊2型糖尿病的临床疗效及安全性分析

目的 探讨利格列汀联合赖脯胰岛素50治疗初诊2型糖尿病(type 2 diabetes mellitus,T2DM)的疗效与安全性.方法 选择2015年1-7月于本科门诊就医,符合纳入及排除标准的131例初诊T2DM患者,最终完成随访的观察组和对照组各61例,包括男性66名,女性56名,年龄(44.6±11.3)岁.观察组采用利格列汀联合赖脯胰岛素50治疗,对照组单用赖脯胰岛素50治疗,比较基线水平和治疗12周后两组空腹血糖、餐后2h血糖、糖化血红蛋白、体质量指数、胰岛素每日需要量、胰岛素抵抗指数变化、随访期间低血糖发生人次.结果 12周后观察组和对照组的空腹血糖、餐后2h血糖、糖化血红蛋白分别降至(6.8±0.6)、(6.6±1.0) mmol/L,(8.9±1.2)、(8.5±1.4) mmol/L,(6.9±1.0)％、(6.7±0.8)％,两组均较基线水平下降显著(P＜0.05),两组下降幅度差异无统计学意义(P＞0.05).两组患者体质量指数治疗前后差异无统计学意义(P＞0.05).观察组每日胰岛素需要量、胰岛素抵抗指数分别降至(15.1±2.2)U、2.92 ±0.21,较基线水平显著下降,差异有统计学意义(P＜0.05).随访期间观察组发生低血糖为7人次,对照组为19人次,差异有统计学意义(P ＜0.05).结论 对于初诊T2DM患者,与单独使用赖脯胰岛素50相比,利格列汀联合赖脯胰岛素50在控制血糖的同时可减少胰岛素使用量,改善胰岛素抵抗,并且更少发生低血糖.     

Switching from human insulin to biphasic insulin aspart 30 treatment gets more patients with type 2 diabetes to reach target glycosylated hemoglobin <7%: the results from the China cohort of the PRESENT study

Background The clinical importance of glycaemic control in patients with diabetes has been well established. This study aimed to explore twice-daily biphasic insulin aspart 30 （BIAsp 30） for insulin initiation in patients with type 2 diabetes mellitus （T2DM） who had poor glycaemic control with human insulins （His）. We use data from a Chinese cohort of the PRESENT study.Methods In the 3-month study, Chinese subjects with T2DM started insulin therapy with BIAsp 30 in routine care. Glycaemic control was measured by glycosylated hemoglobin （HbA1c）, fasting plasma glucose （FPG） and posting plasma glucose （PPG）. The safety assessment included hypoglycaemia and other adverse events.Results A total of 1989 subjects previously treated with His were switched to BIAsp 30 for 3-month treatment. Mean HbA1c, FPG and PPG were significantly improved after the therapy. The overall rate of hypoglycaemia decreased at the end of the trial except for the patients previously treated with long-acting insulin. Most of the events were minor and diurnal hypoglycaemia. Only one serious adverse drug reaction （SADR）, a local hypersensitivity, was reported. The majority of the patients （296.7%） and physicians （≥84.7%） were either satisfied or very satisfied with the treatment using BIAsp 30 compared with previous HI therapy.Conclusion The BIAsp 30 treatment improved both glycaemic control and patients＇ satisfaction without increasing hypoglycaemia in T2DM subjects inadequately controlled by Hls.     

赖脯胰岛素75/25治疗2型糖尿病的疗效观察

目的对比分析预混胰岛素类似物赖脯胰岛素75/25(优泌乐25)和预混人胰岛素(优泌林30R)治疗2型糖尿病对血糖的控制作用和安全性。方法选取2010年9月～2011年10月55例糖尿病患者随机分为两组:赖脯胰岛素75/25组(A组)26例,每日早、晚餐前5min皮下注射赖脯胰岛素75/25;优泌林70/30组(B组)29例,每日早、晚餐前30min注射优泌林70/30。治疗2周后观察患者血糖水平、血糖达标时间。随访3个月,观察HbA1c水平、低血糖发生率、日胰岛素用量等。结果治疗2周后,两组FBG、PBG-2h均有下降,组间比较,PBG-2h下降有统计学意义(P<0.05);达标时间A组低于B组,差异有统计学意义(P<0.05)。随访3个月后,两组HbA1c均有明显下降,A组降低值与B组比较,差异有统计学意义(P<0.05);低血糖发生率、日胰岛素用量两组比较无统计学意义。结论赖脯胰岛素75/25治疗2型糖尿病,可缩短达标时间,HbA1c水平更低,患者具有良好的安全性及依从性。     

Association between four adipokines and insulin sensitivity in patients with obesity, type 1 or type 2 diabetes mellitus, and in the general Chinese population

Background Hyperinsulinemic euglycemic clamp is the gold standard to evaluate the insulin sensitity, but it is too complicated and expensive to use in clinic.We tried to find an alternative indicator to reflect insulin sensitivity.To evaluate the association between the four adipokines, adiponectin, leptin, resistin and tumor necrosis factor-α （TNF-α） with insulin sensitivity, we used a hyperinsulinemic euglycemic clamp to test insulin sensitivity in Chinese patients with obesity and type 1 or type 2 diabetes mellitus versus controls.Methods In this parallel control study, we tested insulin sensitivity using a hyperinsulinemic euglycemic clamp in different groups, then examined levels of adiponectin, leptin, resistin and TNF-α in serum, and the relationship between the different adipokines and glucose disposal rate （M value）, as well as insulin sensitivity index （M value/insulin, M/I）,which are the ＂gold standard＂ indices of insulin sensitivity.Results There were significant differences in mean leptin values in the four adipokines from the four different groups （P〈0.001; comparison of the variation between different groups was analyzed by variance analysis）.Compared to controls （using multiple comparison two-way Dunnett t test）, only the leptin level showed significant differences in the four adipokines from the four different groups at the same time （P 〈0.001）.The association analysis between the different adipokines and M or M/I values also showed that only leptin negatively correlated with M （r=-0.64, P 〈0.001） or M/I values （r=-0.56, P〈0.001）; there was no relationship between the other three adipokines and M or M/I values.Conclusion Only leptin was associated with M or M/I values.Therefore, leptin might be one of the predictive factors of the degree of insulin resistance and risk of the accompanying disease.     

针刺对2型糖尿病患者胰岛素敏感的影响

目的探讨针刺对2型糖尿病患者胰岛素敏感的影响。方法 80例2型糖尿病人随机分为针刺组(n=40)和优降糖组(n=40),针刺组辨证施治12周,优降糖组根据血糖调节剂量持续12周,比较治疗前后体重、空腹血糖(fasting plasmaglucose,FPG)、糖化血红蛋白(glycosylated hemoglobin,GHb)、空腹胰岛素(fasting insulin,FINS),并计算体重指数(body mass in-dex,BMI)、胰岛素敏感指数(insulin sensitivity index,ISI)和稳态模型评估胰岛素抵抗(homeostasis model assessment-insulin re-sistance,HOMA-IR)指数评价胰岛素抵抗状态。结果治疗前针刺组和优降糖组的体重、BMI、FPG、GHb、FINS明显高于正常范围,两组间无统计学差异(P>0.05);治疗后两组FPG、GHb及HOMA-IR均明显下降,ISI明显回升,而针刺组体重、BMI均显著下降(P<0.01),优降糖组体重、BMI无明显下降(P>0.05)。治疗后针刺组FINS下降明显,优降糖组FINS有所上升。治疗后针刺组降低FPG、GHb水平与优降糖组比较无明显差异(P>0.05),而降低FINS的作用明显优于优降糖组(P<0.01)。结论 2型糖尿病患者存在胰岛素敏感指数下降,针刺对体重、FPG、FINS的调节可能是针刺治疗2型糖尿病改善胰岛素抵抗,增加胰岛素敏感的机制之一。     

组织缺氧对2 型糖尿病患者胰岛素抵抗的影响

目的 探讨组织缺氧对2 型糖尿病（T2DM）患者胰岛素抵抗（IR）的影响。方法 选取2015 年1 月- 2016 年10 月该院门诊首次确诊的182 例T2DM 患者作为研究对象。检测所有患者空腹血糖（FPG）、空腹胰 岛素（Fins）、血红蛋白（Hb）、2，3- 二磷酸甘油酸（2，3-DPG）、缺氧诱导因子1α（HIF-1α）及乳酸等水平， 据此计算其胰岛素抵抗指数（HOMA-IR）与胰岛素敏感指数（HOMA-IS）；比较代谢综合征（MS）组（49 例） 和非MS 组（133 例）IR、组织缺氧相关指标，并根据患者Hb 水平的三分位数分成3 组；比较3 组IR、组织 缺氧相关指标。采用Pearson 相关系数分析各指标相关性。结果 MS 组FPG、Fins、HOMA-IR、Hb、HIF-1α 及血乳酸水平高于非MS 组，HOMA-IS 低于非MS 组（P <0.05）。随着Hb 水平提高，Fins、HOMA-IR、 HIF-1α、2，3-DPG 及血乳酸水平逐渐升高（P <0.05），而HOMA-IS 逐渐降低（P <0.05）。HOMA-IR 与 Hb、HIF-1α、2，3-DPG 及血乳酸水平均呈正相关（r =0.197、0.303、0.136 和0.153，P =0.017、0.000、0.067 和0.039），HOMA-IS 与Hb、HIF-1α、2，3-DPG 及血乳酸水平均呈负相关（r =-0.197、-0.303、-0.136 和 -0.153，P =0.017、0.000、0.067 和0.039）。结论 T2DM 患者存在慢性组织缺氧和IR 现象，两者有密切关系； 慢性组织缺氧可能诱发机体代谢紊乱，加速IR。     

诺和锐30与诺和灵30R对2型糖尿病血糖控制研究

目的比较诺和锐30与诺和灵30R控制2型糖尿病餐后血糖的差异.方法 采用随机临床对照试验的方法,将40例2型糖尿病患者分为诺和锐30组和诺和灵30R组,分别皮下注射诺和锐30胰岛素和诺和灵30R胰岛素,监测两组患者餐后血糖控制情况,并进行分析比较.结果两组患者治疗前空腹血糖、餐后血糖值无明显差异,治疗后两组患者空腹血糖值无差异,餐后血糖值差异有统计学意义(P＜0.05).结论诺和锐30控制早餐后血糖的作用优于诺和灵30R.     

三氯化铬对2型糖尿病患者红细胞胰岛素受体的影响

目的探讨三价铬改善糖代谢的作用机制。方法以血铬正常的健康人作对照，将63例血铬降低的T2DM患者的红细胞悬液与不同浓度的三氯化铬进行体外孵育，测定孵育前、后碘标INS与红细胞INS受体结合物的放射性，并进行Scatchard分析。结果T2DM组较对照组血铬显著降低（P〈0．01）；碘标INS与受体的最大特异性结合率及r1、r2均降低（P〈0．01），且空腹INS水平与受体的结合位点之间呈显著的负相关（r=-0．91，P〈0．05）。加入三氯化铬后，与“0”浓度组比较，“100”浓度组仅r1增加（P〈0．01），而“200”及“400”浓度组的最大特异性结合率及r1、r2均增加，k1及k2降低，均有统计学差异。结论三价铬可能通过增加受体的敏摩洼而增加INS与受体的结合率，从而改善IR调节糖代谢。     

2型糖尿病患者动态血糖变化与糖化血红蛋白水平的相关性分析

目的探讨2型糖尿病患者动态血糖变化与糖化血红蛋白（HbAIc）水平的相关性，为预防2型糖尿病并发症的发生提供参考。方法选取2009-05～2011-05收治的18例2型糖尿病患者，采用动态血糖监测系统（CGMS）观察2型糖尿病患者血糖变化与HbAlc的相关性。结果经Pearson分析显示，HbAlc与日内血糖水平呈正相关（P〈0．05），与餐后血糖波动幅度（PPGE）无明显相关性（P〉0．05）。结论CGMS能详细显示13内血糖波动情况，HbAlc能反映日内整体血糖水平。