口服药物联合甘精胰岛素治疗糖尿病效果观察

目的观察口服药物联合甘精胰岛素治疗2型糖尿病的实际效果。方法选取2012年6月—2014年6月80例入住该院的2型糖尿病患者,按硬币法将其分成实验组40例,对照组40例,对照组给予预混胰岛素治疗,实验组联合应用阿卡波糖、甘精胰岛素治疗,观察治疗效果。结果治疗后,比较两组FPG、2 h PG、Hb ALc水平,差异无统计学意义,但实验组低血糖发生率低于对照组(2.5%VS 25.0%,P0.05)。结论联合应用阿卡波糖、甘精胰岛素治疗2型糖尿病患者,疗效满意,安全性高,值得进一步应用。     

糖尿病通过甘精胰岛素联合口服药物治疗的效果分析

目的探讨甘精胰岛素联合口服二甲双胍、呲格列酮治疗糖尿病患者的临床疗效。方法选取2015年6月—2016年6月于该院就诊的额糖尿病患者共80例,随机抽签分为对照组和观察组各40例,对照组给予单纯的口服二甲双胍、呲格列酮治疗治疗,观察组联合使用甘精胰岛素治疗,比较患者空腹血糖及餐后2 h血糖水平,统计患者药物不良反应发生情况。结果治疗后,观察组患者空腹血糖和餐后2 h血糖均显著低于对照组(P0.05),且观察组药物不良反应2.5%,显著低于对照组的22.5%(P0.05)。结论在常规口服药物的基础上联合使用甘精胰岛素治疗糖尿病疾病,能显著降低患者空腹和餐后2 h血糖,达到理想的降糖效果,且药物不良反应少,使用安全性高,具有积极的推广意义。     

甘精胰岛素联合口服药物治疗2型糖尿病肥胖患者的临床观察

将40名FPG≥10mmol/L的肥胖2型糖尿病人(预混胰岛素治疗)随机分成两组,治疗组20例,给予甘精胰岛素联合口服药物(二甲双胍与吡格列酮)治疗,对照组20例仍然采取原预混胰岛素(诺和灵30R)治疗方案。观察12周后,FPG,P2hPG,HbA1c,TG,ALT、AST、BUN、Ccr、HOMA-β和HOMA-IR的变化。结果:治疗组血糖水平达标快,胰岛素用量减少,HbA1c水平降低,同组间治疗后HOMA-β较治疗前增高,HOMA-IR均较治疗前降低,差异具有显著性,治疗组与对照组比较,差异有统计学意义。结论:应用甘精胰岛素联合口服药物(二甲双胍与吡格列酮)治疗可明显改善胰岛素抵抗,血糖达标快,胰岛素用量减少。     

甘精胰岛素与口服药物用于2型糖尿病患者治疗中的临床效果分析

目的讨论甘精胰岛素联合口服药物应用于2型糖尿病患者治疗的临床效果。方法选取该院(2014年5月—2016年5月)收治的94例2型糖尿病患者,随机分为两组,每组47例。对照组仅采取口服药物治疗,观察组采取甘精胰岛素联合口服药物治疗。对两组患者治疗后的血糖控制情况、不良反应发生率以及并发症发生率进行比较分析。结果观察组2型糖尿病患者的不良反应发生率以及并发症发生率均较对照组小;从血糖控制情况看,观察组空腹血糖(5.37±2.03)mmol/L,餐后2小时血糖(8.84±1.9)mmol/L,糖化血红蛋白水平(5.48±1.45)%改善幅度均大于对照组(P0.05)。结论甘精胰岛素联合口服药物应用于2型糖尿病患者治疗的临床效果显著,值得临床应用。     

甘精胰岛素联合瑞格列奈对2型糖尿病的治疗效果分析

目的分析联合甘精胰岛素和瑞格列奈治疗2型糖尿病的效果。方法 100例2型糖尿病患者入组研究,随机分成对照组和治疗组,各50例。两组都采取常规治疗,基于此,对照组单用瑞格列奈,治疗组联合应用甘精胰岛素和瑞格列奈,比较两组治疗效果。结果治疗组总有效率为94.0%,对照组总有效率为76.0%,组间疗效对比差异有统计学意义(P0.05)。结论联合甘精胰岛素和瑞格列奈治疗2型糖尿病,效果确切,推荐使用。     

甘精胰岛素联合瑞格列奈治疗2型糖尿病患者的临床效果分析

目的:研究分析瑞格列奈和甘精胰岛素共同治疗2型糖尿病的效果,为临床用药提供参考依据.方法:2016年9月至2018年9月我院对2型糖尿病患者76例开展了分析研究,将患者分成了对照组和实验组,两组均有38例,对照组使用甘精胰岛素治疗,实验组在对照组基础上增加了瑞格列奈治疗,对两组的血糖情况,治疗有效率等指标进行对比分析....     

甘精胰岛素联合瑞格列奈治疗2型糖尿病的效果分析

目的探讨甘精胰岛素联合瑞格列奈治疗2型糖尿病的效果。方法2018年1—6月期间选取2型糖尿病80例患者,分为对照组(n=40)、观察组(n=40)。对照组采用单一的瑞格列奈治疗,观察组患者在对照组患者用药的基础上加用甘为研究对象精胰岛素进行治疗。比较治疗后效果,对比两组患者治疗前后糖化血红蛋白(HbAlc)、空腹血糖(FBG)、餐后2 h的血糖水平(2 hPG)情况,比较两组患者治疗过程中不良反应发生率。结果观察组总有效率97.50%,对照组总有效率75.00%,组间比较差异有统计学意义(P<0.05),两组患者治疗后各指标情况有一定的改善,观察组各指标改善情况整体优于对照组,差异有统计学意义(P<0.05),对照组患者不良反应发生率明显高于观察组,差异有统计学意义(P<0.05)。结论联合用药治疗2型糖尿病的效果十分理想,患者各指标情况改善明显,治疗疗效确切,两种药物联合使用药物安全性高,临床值得推广使用。     

甘精胰岛素联合瑞格列奈治疗2型糖尿病的效果

目的:研究甘精胰岛素联合瑞格列奈治疗2型糖尿病(T2DM)的效果.方法:选择我院2019年6月至2020年6月的58例T2DM患者.随机数字表法分成各29例的对照组(预混胰岛素治疗)和观察组(甘精胰岛素联合瑞格列奈治疗).对比疗效.结果:经治疗后观察组血糖指标比对照组低,差异有统计学意义(P<0.05).结论:甘精胰岛...     

甘精胰岛素联合瑞格列奈治疗2型糖尿病临床效果分析

目的探讨对2型糖尿病患者应用甘精胰岛素联合瑞格列奈治疗方案的临床效果。方法选择2016年12月—2018年12月期间在该院门诊就诊的90例2型糖尿病患者实施研究,对患者实施随机分组,其中45例设为对比组,均实施预混胰岛素治疗,45例设为实验组,均实施甘精胰岛素联合瑞格列奈治疗。不同治疗方案实施过程中,密切关注两组患者低血糖发生情况,并进行记录。入院时与疗程结束后,分别对两组空腹血糖、餐后2 h血糖水平进行检测。结果入院时两组患者空腹血糖水平以及餐后2 h血糖水平基本相当,但治疗后实验组上述指标检测水平均显著低于对组(P0.05)。治疗方案实施中实验组仅1例患者出现低血糖,低血糖发生率为2.22%,显著低于对比组的13.33%(P0.05)。结论对2型糖尿病患者应用甘精胰岛素联合瑞格列奈治疗方案临床效果确切,可获得更好的血糖水平控制效果。     

沙格列汀联合甘精胰岛素治疗老年2型糖尿病效果分析

目的:分析探讨沙格列汀联合甘精胰岛素治疗老年2型糖尿病效果.方法:选择2019年8月-2020年8月本院收治92例老年2型糖尿病患者临床资料,随机原则分为两组,46例对照组使用甘精胰岛素治疗,46试验组在对照组甘精胰岛素治疗基础上联合沙格列汀治疗,比较两组临床效果与血糖指标.结果:经治疗,试验组总有效率93.48％高于...     

甘精胰岛素联合二甲双胍在改善2型糖尿病患者胰岛功能中的应用

目的分析甘精胰岛素联合二甲双胍在改善2型糖尿病患者胰岛功能中的应用效果。方法 2017年3月-2018年8月在该中心遴选84例2型糖尿病患者,随机分为治疗组(n=42例)和对照组(n=42例),分别应用甘精胰岛素联合二甲双胍治疗、单独的甘精胰岛素治疗。比较两组疗效,观察空腹血糖等血糖指标和空腹胰岛素等胰岛功能指标的变化,记录不良反应。结果治疗组的总有效率为92.86%,比对照组的76.19%效率更高,差异有统计学意义(P<0.05);治疗组的不良反应发生率为11.9%,对照组为16.67%,差异无统计学意义(P>0.05)。结论甘精胰岛素联合二甲双胍在改善2型糖尿病患者胰岛功能中的应用临床效果显著。     

在2型糖尿病治疗中甘精胰岛素联合瑞格列奈的应用安全性分析

目的 评价对2型糖尿病患者应用甘精胰岛素联合瑞格列奈的临床价值以及安全性分析.方法 选取时间为2017年9月—2019年4月,对该医院收治的138例2型糖尿病患者开展研究,采用数字随机表法将其平均分成2组(实验组与参照组),每组69例.其中参照组运用诺和灵30R治疗,实验组运用甘精胰岛素联合瑞格列奈治疗.对其治疗前后血...     

Spotlight on Insulin Glargine in Type 1 and 2 Diabetes Mellitus

Insulin glargine is a recombinant human insulin analog produced by DNA technology using a nonpathogenic strain of Escherichia coli. Two modifications of human insulin result in a stable molecule which is soluble in slightly acidic conditions (pH 4.0) and precipitates in the neutral pH of subcutaneous tissue. Because of these properties, absorption of insulin glargine is delayed and the analog provides a fairly constant, basal insulin supply without peaks in plasma insulin levels for approximately 24 hours, similar to that achieved by a continuous subcutaneous insulin infusion. Insulin glargine is indicated as a once daily subcutaneous injection to provide basal glycemic control in adults and children aged >6 years with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus. Fasting plasma glucose and fasting blood glucose levels generally improved to a greater extent in patients with type 1 diabetes mellitus receiving insulin glargine than patients who administered Neutral Protamine Hagedorn (NPH) insulin. In patients with type 1 or 2 disease, glycosylated hemoglobin levels were slightly reduced and to a similar extent with insulin glargine and NPH insulin. Most clinical trials in patients with type 1 or 2 diabetes mellitus demonstrated a lower incidence of hypoglycemia, especially nocturnal hypoglycemia, with insulin glargine compared with NPH insulin. One of the most common adverse events with insulin glargine treatment was injection site pain which, in some studies, occurred more frequently than in patients receiving NPH insulin. In all cases the symptoms were mild and treatment discontinuation was not required. Otherwise, the drug is well tolerated and does not appear to be immunogenic. In conclusion, insulin glargine once a day provides basal control of glycemia for approximately 24 hours without inducing peaks in plasma insulin levels in patients with type 1 or 2 diabetes mellitus. In long-term, well designed trials insulin glargine once daily improved glycemic control at least as effectively as NPH insulin given once or twice daily. The drug was well tolerated and in most studies the incidence of nocturnal hypoglycemia was significantly less in patients treated with insulin glargine compared with patients receiving NPH insulin. Therefore, insulin glargine is likely to be a useful addition to the armamentarium of insulin therapy by establishing basal glycemic control with once daily administration and a reduced risk of nocturnal hypoglycemia.     

2型糖尿病治疗中甘精胰岛素联合口服降糖药的应用与疗效评价

目的 将甘精胰岛素与口服降糖药联合应用于2型糖尿病的效果进行分析.方法 选取2018年9月—2019年9月在该院接受2型糖尿病治疗的100例患者,按照抽签法均分样本为综合治疗组和口服降糖组,口服降糖组选择口服降糖药即二甲双胍治疗,综合治疗组选择以口服降糖组为基础实施甘精胰岛素治疗,评估两组临床疗效、治疗前后的血糖指标以...     

甘精胰岛素联合瑞格列奈治疗2型糖尿病有效性及安全性评估

目的探讨针对2型糖尿病患者,观察选择甘精胰岛素+瑞格列奈完成治疗后获得的临床效果。方法选择该院2013年2月—2015年2月2型糖尿病患者70例。通过随机数表法完成2型糖尿病患者的随机分组。C2组(对照组35例):临床选择胰岛素皮下注射的方法实施治疗。C1组(观察组35例):临床选择甘精胰岛素+瑞格列奈进行治疗。对比两组2型糖尿病患者完成治疗后在相关指标方面表现出的差异。结果两组2型糖尿病患者完成治疗后,在Hb Alc水平方面,C1组明显优于C2组2型糖尿病患者,差异有统计学意义(P0.05)。结论针对2型糖尿病患者,临床选择甘精胰岛素+瑞格列奈进行治疗,针对患者的血糖稳定性能够有效进行维持,将患者的胰岛素用量能够有效降低,避免患者出现低血糖的情况,凸显两种药物联合治疗2型糖尿病疾病的临床价值。     

小儿Ⅰ型糖尿病应用门冬胰岛素与甘精胰岛素联合治疗的效果

目的探究小儿Ⅰ型糖尿病联合应用门冬胰岛素与甘精胰岛素的治疗效果。方法选取2018年1—12月该院收治的86例小儿Ⅰ型糖尿病患儿,将患儿随机分为单纯1组和联合2组,每组43例。联合2组给予门冬胰岛素+甘精胰岛素治疗;单纯1组给予门冬胰岛素治疗。比较两组血糖水平、低血糖发生率、胰岛素用量及治疗满意度。结果治疗前,两组血糖水平比较差异无统计学意义(P>0.05);治疗后,联合2组血糖水平低于单纯1组,胰岛素用量低于单纯1组,联合2组治疗满意度高于单纯1组,差异有统计学意义(P<0.05)。结论若患有小儿Ⅰ型糖尿病,则使用门冬胰岛素+甘精胰岛素治疗,效果显著,有利控制患儿血糖评分,同时降低低血糖发生率以及胰岛素用量,提高治疗满意度,可临床推广应用。     

甘精胰岛素联合二甲双胍治疗血糖控制不佳2型糖尿病的临床价值

目的探讨分析甘精胰岛素联合二甲双胍治疗血糖控制不佳2型糖尿病的临床疗效。方法选取该院2012年12月—2013年12月收治的101例口服降糖药血糖控制不佳的2型糖尿病患者为研究对象,将其依数字表法随机分成两组,观察组55例患者给予甘精胰岛素联合二甲双胍治疗,对照组46例患者给予精蛋白锌胰岛素联合二甲双胍治疗,观察两组临床疗效。结果两组患者空腹血糖(FBG)、餐后2 h血糖(2h PG)及糖化血红蛋白(Hb Alc)水平均较治疗前有所改善,观察组改善情况显著优于对照组,差异有统计学意义(P<0.05);两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论甘精胰岛素联合二甲双胍治疗血糖控制不佳的2型糖尿病,临床疗效较显著。     

甘精胰岛素联合格列美脲治疗120例老年糖尿病的临床效果

目的总结分析在老年糖尿病治疗中甘精胰岛素联合格列美脲的临床应用效果。方法选择该中心2017年7月-2019年1月期间接诊的120例老年糖尿病患者作为该组的研究分析对象,将其按照治疗方法的差异随机分组,其中对照组选择的是重组人胰岛素治疗,观察组患者选择的治疗方案是甘精胰岛素与格列美脲联合用药,观察比较两组治疗前后血糖、血脂水平变化,治疗有效率、胰岛素相关指标等。结果 (1)两组血糖控制总有效率分别为90.00%、75.00%,观察组临床总有效率更高差异有统计学意义(χ^2=4.675,P<0.05);(2)两组治疗后血糖、血脂水平明显好转,但观察组患者血糖、血脂改善效果更佳差异有统计学意义(P<0.05);(3)观察组治疗后的胰岛素相关指标更佳差异有统计学意义(P<0.05)。结论老年糖尿病治疗中甘精胰岛素联合格列美脲的临床降糖效果满意,同时有助于血脂代谢调节。     

The DURABLE Trial Study Design: Comparing the Safety, Efficacy, and Durability of Insulin Glargine to Insulin Lispro Mix 75/25 Added to Oral Antihyperglycemic Agents in Patients with Type 2 Diabetes

Background

While studies have compared the safety and efficacy of starter insulin regimens in type 2 diabetes, none have evaluated regimen durability (length of time a patient can maintain glycemic control) or the safety and efficacy of subsequent intensification regimens in a large, multinational cohort.

Methods

The DURABLE (Assessing the DURAbility of Basal vs Lispro Mix 75/25 Insulin Efficacy) trial will compare the ability of glargine once daily vs lispro mix 75/25 (75% insulin lispro protamine suspension, 25% lispro) twice daily added to oral antihyperglycemic agents to achieve and maintain hemoglobin A1c (HbA1c) goals. This randomized, open label, parallel study will enroll over 2000 insulin-naïve patients with type 2 diabetes from 11 countries, ages 30 to 80, with HbA1c >7.0% on at least two oral antihyperglycemic agents. At the completion of the 6-month initiation phase, safety and efficacy of the two regimens will be compared. Patients who achieve an HbA1c ≤7.0% at 6 months will continue into the 24-month maintenance phase to evaluate durability.In a substudy, patients not achieving HbA1c ≤7.0% at 6 months may be randomized to one of two intensification comparisons: patients previously on glargine will receive lispro mix 75/25 twice daily or basal/bolus therapy (glargine + thrice-daily mealtime lispro) and patients previously on lispro mix 75/25 will receive lispro mix 50/50 (50% insulin lispro protamine suspension, 50% lispro) thrice daily or basal/bolus therapy.

Results

Upon completion, this trial will provide new information about starter insulin durability, defined as the length of time patients can maintain HbA1c control (HbA1c ≤7.0%, or >7.0% but with an increase of <0.4% from the most recent HbA1c ≤7.0%). Additionally, the study will provide comparative data on HbA1c, blood glucose profiles, 1,5-anhydroglucitol, hypoglycemic episodes, weight change, and insulin dose for starter insulin regimens following 6 and 24 months of treatment, as well as intensified insulin via the 6-month substudy.

Conclusion

This trial aims to broaden clinicians'' understanding of the ability of starter insulin and insulin intensification regimens to achieve and maintain glycemic control in patients with type 2 diabetes.     

Trends in Insulin Initiation and Treatment Intensification Among Patients with Type 2 Diabetes

BACKGROUND

Many patients with type 2 diabetes eventually require insulin, yet little is known about the patterns and quality of pharmacologic care received following insulin initiation. Guidelines from the American Diabetes Association and the European Association for the Study of Diabetes recommend that insulin secretagogues such as sulfonylureas be discontinued at the time of insulin initiation to reduce the risk of hypoglycemia, and that treatment be intensified if HbA1c levels remain above-target 3 months after insulin initiation.

OBJECTIVE

To describe pharmacologic treatment patterns over time among adults initiating insulin and/or intensifying insulin treatment.

DESIGN

Observational study.

SUBJECTS

A large commercially insured population of adult patients without recorded type 1 diabetes who initiated insulin.

MAIN MEASURES

We evaluated changes in non-insulin antidiabetic medication use during the 120 days immediately following insulin initiation, rates of increase in insulin dose and/or dosing frequency during the 270 days following an insulin initiation treatment period of 90 days, and rates of insulin discontinuation.

KEY RESULTS

Seven thousand, nine hundred and thirty-two patients initiated insulin during 2003–2008, with the majority (61 %) initiating basal insulin only. Metformin (55 %), sulfonylureas (39 %), and thiazolidinediones (30 %) were commonly used prior to insulin initiation. Metformin was continued by 64 % of patients following mixed or mealtime insulin initiation; the continuation rate was nearly as high for sulfonylureas (58 %). Insulin dose and/or dosing frequency increased among 22.9 % of patients. Insulin was discontinued by 27 % of patients.

CONCLUSIONS

We found evidence of substantial departures from guideline-recommended pharmacotherapy. Insulin secretagogues were frequently co-prescribed with insulin. The majority of patients had no evidence of treatment intensification following insulin initiation, although this finding is difficult to interpret without HbA1c levels. While each patient’s care should be individualized, our data suggest that the quality of care following insulin initiation can be improved.