来得时联合拜唐苹和诺和锐30治疗口服降糖药疗效不佳的高龄2型糖尿病患者的临床观察

目的探讨来得时联合拜唐苹和诺和锐30治疗高龄（80岁以上）2型糖尿病（T2DM）患者血糖、糖化血红蛋白（HbA1c）变化，低血糖事件发生率及临床意义。方法将120例口服降糖药物疗效较差的高龄T2DM患者随机分为来得时联合拜唐苹组和诺和锐30组（每组60例）。来得时联合拜唐苹组每日早餐前注射1次来得时加三餐中口服拜唐苹，诺和锐30组早晚餐前各皮下注射1次，共16周，比较两组患者空腹血糖（FBG）及餐后2小时血糖（2hPBG）、甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C），高密度脂蛋白胆固醇（HDL-C）、HbA1c的下降情况，低血糖事件发生率。结果两组治疗前后血糖、TG、TC、LDL-C、HbA1c下降明显，其中来得时联合拜唐苹组HbA1c从（8.8%±2.0%）下降至（7.1%±1.2%）；诺和锐30组HbA1c从（8.9%±2.4%）下降到（7.0%±1.2%）；治疗后两组之间差异无统计学意义（P＞0.05）；来得时联合拜唐苹组低血糖事件发生率明显低于诺和锐30组（3.3%vs 13.3%，P＜0.01）。结论来得时联合拜唐苹组和诺和锐30组都具有明显降低FBG、2hPBG、TG、TC、LDL-C、HbA1c的作用，来得时联合拜唐苹组低血糖事件发生率明显低于诺和锐30组。

Lantus with glucobay vs Novomix 30 in treatment of very old patients with type 2 diabetes poorly controlled by oral hypoglycemic drugs

Objective To investigate the changes of blood glucose, HbA1c, and incidence of hypoglycemia in the very old patients （over 80 years） with type 2 diabetes mellitus （T2DM） after the treatment of lantus with glucobay or Novomix 30, and the clinical significance. Methods A total of 120 very old T2DM patients poorly controlled with oral hypoglycemic drugs admitted in our department from July 2011 to June 2012 were subjected in this study. They were randomly divided into lantus with glucobay group and Novomix 30 group （n=60 in each group）. Lantus was injected before breakfast, and glucobay was taken with meals, while Novomix 30 was injected before morning and evening meals for total 16 weeks. Fasting blood glucose （FBG） and 2-hour postprandial blood glucose （2hPBG）, triglycerides （TG）, total cholesterol （TC）, low-density lipoprotein cholesterol （LDL-C）, high-density lipoprotein cholesterol （HDL-C）, the decrease of HbA1c, and the incidence of hypoglycemia were compared between the two groups. Results After the treatment, blood glucose, TG, TC, LDL-C and HbA1c were decreased in the two groups though without significant difference （P〉0.05）. HbA1c was decreased from （8.8%±2.0%） to （7.1%±1.2%） in the glucobay group, and from （8.9%±2.4%） to （7.0%±1.2%） in Novomix 30 group, with no significant difference between them （P〉0.05）. The incidence of hypoglycemia was significantly lower in glucobay group than in Novomix 30 group （3.3% vs 13.3%, P〈0.01）. Conclusion Lantus combined with glucobay and Novomix 30 have the similar improvement in FBG, 2hPBG, TG, TC, LDL-C and HbA1c. But the combination with glucobay has significantly lower incidence of hypoglycemia.