不同时效胰岛素联合使用的必要性和安全性监测

目的 探讨不同时效胰岛素联合治疗糖尿病的临床疗效及安全性.方法 选择2013年1月至12月于我院就诊的120例2型糖尿病患者,简单随机分为试验组和对照组各60例.对照组单独使用精蛋白合成人胰岛素注射液（预混30R）或门冬胰岛素30,试验组采用白天注射另外两种胰岛素、晚上睡前再分别加用甘精胰岛素或地特胰岛素进行治疗.所有患者均在分组前及研究结束时化验糖化血红蛋白,治疗期间每天测空腹血糖、三餐前后2h血糖和睡前血糖,记录低血糖发生率.结果 两组治疗后所有血糖水平除对照组午餐后2h血糖外均较治疗前明显下降,差异有统计学意义（P＜0.05）,其中试验组患者的血糖控制水平明显较对照组好,差异有统计学意义（P＜0.05）;试验组患者的低血糖反应发生率为10％,对照组的低血糖反应发生率为25％,两组患者低血糖反应发生率相比较,差异有统计学意义（x2=4.2702,P=0.0388）.结论 不同时效胰岛素联合治疗糖尿病有效,且低血糖发生率低,适合长期推广应用.

Surveillance on necessity and safety of combined use of different aging insulin

Objective To analyze the necessity and safety of combined use of different aging insulin.Methods 120 cases of type 2 diabetes were selected in our hospital from January to December 2013,they were randomly divided into a test group of 60 patients and a control group of 60 patients,the control group used protamine synthetic human insulin injection （pre-mixed 30R） or insulin aspart 30,while the experimental group before going to bed at night were added with insulin glargine or detemir.Then we observed glycated hemoglobin,fasting blood glucose measurements every day during treatment,before and after meals and at bedtime 2h blood glucose,and recorded incidence of hypoglycemia.Results After treatment,blood glucose decreased,the difference was statistically significant （P ＜ 0.05）.Blood glucose in the test group was better than that of the control group,the difference was statistically significant （P ＜ 0.05）,the incidence of low blood sugar reaction in the test was 10.0％,which was lower than that of the control group of 25.0％,and the difference was statistically significant （x 2--4.2702,P=0.0388）.Conclusion Different aging insulin combination in the treatment of diabetic is effective,which has low incidence of hypoglycemia and worthy of long-term promotion and application.