甘精胰岛素联合门冬胰岛素治疗2型糖尿病的临床评价

目的 评价甘精胰岛素联合门冬胰岛素治疗对2型糖尿病患者的血糖控制效果。方法 选取上海市长宁区天山中医医院内分泌科2013年1月-2016年1月治疗的2型糖尿病患者150例，随机分为两组（n=75）。其中对照组75例采用精蛋白生物合成人胰岛素注射液联合三餐门冬胰岛素治疗；试验组75例采用甘精胰岛素联合三餐门冬胰岛素治疗，均用药6个月。比较两组治疗前后空腹血糖、餐后2 h血糖和糖化血红蛋白（HbA1c）水平、两组生存质量和不良反应情况。结果 治疗6个月时，对照组和试验组患者的空腹血糖、餐后2 h血糖和HbA1c水平均较同组治疗前降低（P<0.05），且试验组的空腹血糖和HbA1c水平均低于对照组的（P<0.05），试验组生存质量明显优于对照组（P<0.05）；治疗3个月时，试验组的HbA1c水平低于对照组的，差异均有统计学意义（P<0.05）。试验组轻微低血糖、夜间低血糖和心脑血管发生率明显低于对照组（P<0.05）。结论 甘精胰岛素联合门冬胰岛素治疗对2型糖尿病患者的血糖控制效果显著，可长时间将血糖稳定在正常水平，患者不良反应发生率低、生存质量高。

Clinical evaluation of insulin glargine combined with insulin aspart in treatment of patients with type 2 diabetes

Objective To explore the effect of insulin glargine combined with insulin aspart treatment on blood glucose control in type 2 diabetic patients.Methods A total of 150 cases of patients with type 2 diabetes who underwent treatment in department of Endocrinology, Tianshan Traditional Chinese Medicine Hospital from January 2013 to January 2016 were selected and divided into control group and experiment group by a random number table method, with 75 cases in each group. Patients in the control group were treated with Novolin N combined with insulin aspart. Patients in the experiment group were treated with the insulin glargine combined with insulin aspart. The levels of fasting blood glucose, postprandial 2 h blood glucose and glycosylated hemoglobin (HbA1c) were compared before and after treatment in the two groups, and the quality of life and adverse reactions in the two groups were analyzed.Results At treatment of six months, the levels of fasting blood glucose, postprandial 2 h blood glucose and HbA1c were lower in two groups than those before treatment (P< 0.05), while the levels of fasting blood glucose and HbA1c in the experimental group was lower than those in the control group (P< 0.05). The quality of life in the experimental group was obviously better than that of the control group (P< 0.05). At treatment of three months, the level of HbA1c in experiment group was lower than that in control group (P< 0.05), the differences in which were statistically significant (P< 0.05).The incidence of mild hypoglycemia, nocturnal hypoglycemia and cardio-cerebral vascularization in the experimental group was significantly lower than those in the control group (P< 0.05).Conclusion Insulin glargine combined with insulin aspart has a significant effect on blood glucose control in patients with type 2 diabetes mellitus, which can stabilize blood glucose for a long time at a normal level, reduce the incidence of adverse reactions, and improve the quality of life.