地特胰岛素或甘精胰岛素联合使用口服药物治疗2型糖尿病疗效及对体重的影响分析

目的 观察地特胰岛素或甘精胰岛素联合口服药物治疗T2DM的疗效及对体重的影响。方法 80例T2DM患者随机分为Det组和Gla组，每组40例。Det组采用阿卡波糖+二甲双胍+地特胰岛素治疗，Gla组采用阿卡波糖+二甲双胍+甘精胰岛素治疗。治疗12周后对比两组患者治疗前后HbA1C、FPG、2hPG、基础胰岛素用量、体重变化以及低血糖发生率。结果 两组患者FPG、2hPG及HbA1C均到有效控制，Det组HbA1C由（9.6±2.1）%降至（6.8±0.6）%，Gla组HbA1C由（9.2±2.1）%降至（6.4±0.7）%。Det组及Gla组FPG分别由（10.5±2.3）mmol/L、（10.6±2.4）mmol/L降至（6.1±0.6）mmol/L、（6.3±0.7）mmol/L；2hPG分别由（14.9±2.3）mmol/L、（14.5±2.1）mmol/L降至（9.1±1.1）mmol/L、（9.2±1.3）mmol/L，差异均具有统计学意义（P＜0.05）。达到同样空腹血糖水平，Det组基础胰岛素用量为（0.40±0.05）U/kg，少于Gla组的（0.60±0.04）U/kg，差异具有统计学意义（P＜0.05）。治疗12周后，Det组体重增加（1.3±0.4）kg，Gla组体重增加（2.5±0.3）kg，Det组体重增加低于Gla组，差异具有统计学意义（P＜0.05）。Gla组低血糖发生率为5.00%，Det组低血糖发生率为2.50%，两组间比较，差异无统计学意义（P＞0.05）。结论 T2DM患者口服药物联合基础胰岛素控糖是一种安全有效的选择，地特胰岛素对体重增加方面更有优势。

Effect of Insulin Detemir or Insulin Glargine Combined with Oral Medication on Type 2 Diabetes Mellitus and its Influence on Body Weight

Abstract:Objective To observe the effect of insulin or insulin glargine combined with oral drugs on T2DM and its effect on body weight.Methods 80 patients with T2DM were randomly divided into Det group and Gla group,40 cases in each group.Group Det was treated with acarbose+metformin+insulin.Gla group was treated with acarbose+metformin plus+glargine.After treatment for 12 weeks,the HbA1C,FPG,2hPG,basal insulin dosage,body weight and incidence of hypoglycemia were compared between the two groups before and after treatment.Results Both FPG,2hPG,and HbA1C were effectively controlled in both groups, HbA1C in the Det group decreased from(9.6±2.1)% to(6.8±0.6)%,and HbA1C in the Gla group decreased from(9.2±2.1)% to(6.4±0.7)%.FPG in Det group and Gla group decreased from(10.5±2.3)mmol/L,(10.6±2.4)mmol/L to(6.1±0.6)mmol/L,(6.3±0.7)mmol/L, respectively;2hPG decreased from(14.9±2.3)mmol/L and(14.5±2.1)mmol/L to(9.1±1.1) mmol/L and(9.2±1.3)mmol/L,respectively,with statistical significance(P<0.05).To achieve the same fasting blood glucose level,the basal insulin dosage in the Det group was(0.40±0.05)U/kg,which was lower than that in the Gla group(0.60±0.04)U/kg,and the difference was statistically significant (P<0.05).After 12 weeks of treatment,the body weight of Det group increased(1.3±0.4)kg,while that of Gla group increased(2.5±0.3)kg.The weight gain of Det group was lower than that of Gla group,and the difference was statistically significant(P<0.05).The incidence of hypoglycemia was 5.00% in the Gla group and 2.50% in the Det group.There was no significant difference between the two groups(P>0.05).Conclusion Oral administration of T2DM in combination with basal insulin control is a safe and effective choice,insulin detemir has an advantage in weight gain.