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目的观察基础胰岛素对于口服降糖药(OAD)控制不佳的T2DM的临床疗效和安全性。方法 60例OAD控制不佳的T2DM患者睡前分别加用地特胰岛素(Det)、甘精胰岛素(Gla)和中性鱼精蛋白胰岛素(NPH),每组20例治疗12周。结果 3组FBG、2hBG、HbA1c均较基线下降(P<0.01),但组间差异无统计学意义(P>0.05)。Det组和Gla组低血糖发生率均为5%,低于NPH组30%(P<0.05)。Det组体重增加(0.7±0.34)kg,低于Gla组(1.43±0.35)kg和NPH组(1.42±0.32)kg(P<0.01)。3组胰岛素用量和达标时间比较无统计学差异(P>0.05)。结论对于口服降糖药控制不佳的T2DM患者加用地特或甘精胰岛素更安全;地特胰岛素在体重控制方面更有优势。
Objective To observe the clinical efficacy and safety of basal insulin in T2DM patients with poorly controlled oral hypoglycemic agents (OAD). Methods Sixty patients with poor OAD control were enrolled in this study. Det, Insulin (Gla) and Neutrophil Insulin (NPH) were added before bedtime in each group. Twenty patients in each group were treated for 12 weeks. Results The FBG, 2hBG and HbA1c in 3 groups decreased from baseline (P <0.01), but there was no significant difference between groups (P> 0.05). The incidence of hypoglycemia in Det and Gla groups was 5%, lower than that in NPH group (P <0.05). The body weight of Det group (0.7 ± 0.34) kg was significantly lower than that of Gla group (1.43 ± 0.35) kg and NPH group (1.42 ± 0.32) kg (P <0.01). There was no significant difference between the three groups in the amount of insulin and the standard time (P> 0.05). Conclusions It is safer to use dextromethorpol or insulin glargine for T2DM patients with poorly controlled oral hypoglycemic agents, and insulin detemir more for weight management.