地特胰岛素在2型糖尿病胰岛素起始治疗中的疗效分析

目的：对HbA1c＆gt;9%的新诊断的T2DM患者进行地特胰岛素（Det）联合二甲双胍的短期强化治疗，探讨Det作为基础胰岛素在T2DM起始治疗中的疗效与安全性。方法：156例新诊断的T2DM患者随机数字表法分为治疗组与对照组，每组78例，两组在口服二甲双胍的基础上，治疗组给予Det联合二甲双胍治疗，对照组给予门冬胰岛素30联合二甲双胍治疗，治疗12周。对其治疗前后血糖控制、低血糖情况和HOMA-β功能进行自身及组间比较。结果：12周治疗后，两组中FBG、2 h PBG、HBA1c较治疗前均明显下降，FC-P、2 h C-P和HOMA-β较治疗前明显升高（P〈0.01）。治疗组低血糖发生率3.85%（3/78）、症状性低血糖1例，对照组24.36%（19/78）、症状性低血糖5例，Det明显优于门冬胰岛素30，比较差异有统计学意义（P〈0.01）。结论：Det作为基础胰岛素联合二甲双胍治疗新诊断时HbA1c＆gt;9%的T2DM患者可以良好控制高血糖且低血糖发生率低，是一种简单、有效、安全的门诊强化治疗方案，适合初诊2型糖尿病的起始治疗。

The Therapeutic of Effect of Insulin Detemir in Initial Treatment for Type 2 Diabetic Patients

T2DM patients with HbA1c＆gt;9%were newly diagnosed insulin detemir（Det）combined short-term intensive treatment with metformin explore Det as the basis for the initial treatment of insulin in T2DM efficacy and safety. Method：156 newly diagnosed T2DM patients were randomly divided into treatment group and control group, and 78 cases in each group. The two groups on the basis of oral metformin,the treatment group was given metformin therapy Det,the control group was given insulin aspart 30 combined metformin for 12 weeks. Their blood glucose control before and after treatment,low blood glucose and HOMA-βfunction between themselves were compared. Result：After 12 weeks of treatment,both groups FBG,2 h PBG,HBA1c were significantly lower than before treatment,FC-P,before 2 h C-P and HOMA-βwere significantly higher than before treatment（P〈0.01）. Incidence of hypoglycemia in the treatment group was 3.85%（3/78）,one case of symptomatic hypoglycemia,24.36%in the control group（19/78）,five cases of symptomatic hypoglycemia,Det was much better than insulin aspart 30（P〈0.01）,the difference was statistically significant. Conclusion：When Det as basal insulin combined with metformin therapy in newly diagnosed HbA1c＆gt;9%of patients with T2DM can be well controlled high blood sugar and low incidence of hypoglycemia is a simple,effective and safe outpatient intensive treatment program for newly diagnosed type 2 initial treatment of diabetes.