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目的比较睡前注射地特胰岛素和中性鱼精蛋白锌胰岛素(Neutral Protamine Hagedorn,NPH)联合口服降糖药(OAD)对OAD控制不佳的2型糖尿病(Diabetes Mellitus,DM)患者血糖控制的影响。方法共入选36例2型DM患者,随机给予睡前注射地特胰岛素和NPH治疗。分别于治疗前后测定HbA1c、FBG及行动态血糖监测(Continuous Glucose Monitoring System,CGMS)。结果 20周时地特组和NPH组HbA1c分别由9.19%和8.72%降至7.81%和7.39%,FBG分别由11.7mmol/L和11.0mmol/L降至6.59mmol/L和6.29mmol/L(P<0.05),治疗前后两组间无统计学差异。地特组血糖变异系数较治疗前显著下降,并显著低于NPH组。治疗前后地特组和NPH组的体质量增加分别为(-1.22±1.84)kg和(2.19±2.81)kg(P<0.05)。地特素组低血糖事件发生率明显低于NPH组,且无夜间低血糖事件。结论地特胰岛素联合OAD治疗与NPH具有相似的血糖控制,但地特胰岛素治疗的患者血糖控制更加平稳。
Objective To compare the effects of bedtime injection of insulin and Neutral Protamine Hagedorn (NPH) with oral hypoglycemic agents (OAD) on glycemic control in patients with type 2 diabetes mellitus (DM) with poorly controlled OAD influences. Methods A total of 36 patients with type 2 DM were enrolled and randomly assigned to receive insulin detemir and NPH at bedtime. HbA1c, FBG and Continuous Glucose Monitoring System (CGMS) were measured before and after treatment. Results At 20 weeks, the HbA1c in geotech group and NPH group decreased from 9.19% and 8.72% to 7.81% and 7.39% respectively, FBG decreased from 11.7mmol / L and 11.0mmol / L to 6.59mmol / L and 6.29mmol / L respectively P <0.05), no significant difference between the two groups before and after treatment. In the special group, the coefficient of variation of blood glucose was significantly lower than that before treatment, and was significantly lower than that of NPH group. Before and after treatment, the increase of body weight in the special treatment group and the NPH group was (-1.22 ± 1.84) kg and (2.19 ± 2.81) kg (P <0.05), respectively. The incidence of hypoglycaemic events in the Decatur group was significantly lower than that in the NPH group and there was no nocturnal hypoglycemic event. Conclusions Detemir plus OAD has similar glycemic control with NPH, but insulin detemir has a more stable glycemic control.