使用不同胰岛素类似物治疗老年2型糖尿病

目的用动态血糖监测方法评价两种预混胰岛素类似物治疗2型糖尿病（T2DM）时血糖漂移和低血糖发生率的差异，为临床使用提供参考。方法选取一般情况匹配且需要胰岛素治疗的老年2型糖尿病患者64例，随机分为2组。分别使用门冬胰岛素30注射液和赖脯胰岛素25注射液进行治疗。在血糖达标前提下，采用动态血糖监测的方法，评价两组患者血糖漂移和低血糖发生率的差异。结果两组患者血糖达标时，胰岛素总量无统计学差异（38．0±6．2）w（40．0±5．1）U／d，P〉0．05]。两组平均血糖漂移幅度（6．32±1．43）VS（6．86±1．51）mmol／L，P〉0．05]及血糖漂移系数（1．35±0．22）VS（1．41±0．13），P〉0．05]均无统计学差异。赖脯胰岛素25注射液低血糖事件少于门冬胰岛素30组，但差异无统计学意义（12％vs8％，P〉0．05）。结论门冬胰岛素30注射液和赖脯胰岛素25注射液治疗老年2型糖尿病，在血糖控制良好时，胰岛素总量、血糖漂移及低血糖发生率相当。

Different premixed insulin for type 2 diabetes mellitus in the elderly

Objective To compare the degree of glycemia variability（GV） and hypoglycemia incidence by dynamic glucose monitoring in elderly patients with type 2 diabetes mellitus （T2DM） who were treated with different premixed insulin. Methods A total of 64 patients （≥60years） with type 2 diabetes were included. The general data were matched, and all patients required insulin treatment. The patients were randomly divided into two groups, and treated with biphasic insulin aspart 30 or insulin lispro mix 25 respectively. Predicating the blood glucose concentrations within normal range, difference in GV and hypoglycemia incidence between the two groups were analyzed by dynamic glucose monitoring. Results When patients had normal level of blood glucose, there was no significant difference in total insulin between two groups （38.0± 6.2） vs （40.0 ± 5.1） U/d, p〉 0.05]. There was no statistical difference found in the mean blood glucose drift rate （6.32 ± 1.43） vs （6.86 ± 1.51） mmol/L, P 〉 0.05] or glucose drift coefficient （1.35 ± 0.22） vs （1.41 ± 0.13）, P 〉 0.05]. Injection events in insulin lispro mix 25 hypoglycemic were less than that in insulin aspart 30 group, but the difference was not statistically significant （12% vs 8%, P 〉 0.05）. Conclusion When the blood glucose was under good control, insulin aspart 30 and insulin lispro mix 25 have similar effects for elderly patients with type 2 diabetes, including the total amount of insulin, glucose rate of drift and the incidence of hypoglycemia.