妊娠糖尿病忘记打地特胰岛素【地特胰岛素联合格列美脲对2型糖尿病的疗效观察】

　　[摘要] 目的 探讨地特胰岛素联合格列美脲治疗2型糖尿病的临床疗效。 方法 选取2011年3月～2012年3月我院收治住院的诊断为2型糖尿病的患者70例，将其随机分为观察组和对照组，各35例，观察组采用地特胰岛素（Det）联合格列美脲治疗，对照组采用中性低精蛋白锌人胰岛素（NPH）联合格列美脲治疗，均治疗6个月，监测两组治疗前后体重、空腹血糖（FBG）、餐后2 h血糖（2 h PG）、糖化血红蛋白（HbA1c）、体质量指数（BMI）的变化，记录血糖达标时间、低血糖发生率及胰岛素用量，计算胰岛B细胞功能（Homa-B）和胰岛素抵抗（Homa-IR）。 结果 治疗前两组患者的FBG、2 h PG、HbA1c、BMI及Homa-B和Homa-IR差异均无统计学意义（P ＞ 0.05）；治疗后两组FBG、2 h PG及HbA1c均明显下降，治疗前后差异有统计学意义（P ＜ 0.05）；观察组BMI下降较对照组明显，差异有统计学意义（P ＜ 0.05）。观察组血糖达标时间、低血糖发生率及胰岛素用量均低于对照组，差异有高度统计学意义（P ＜ 0.01）。 结论 与中性低精蛋白锌人胰岛素相比，地特胰岛素治疗2型糖尿病疗效更显著，低血糖发生率较低，能较好地控制患者体重，方法简单易行、安全有效，值得临床推广应用。
　　[关键词] 2型糖尿病；地特胰岛素；中性低精蛋白锌人胰岛素；格列美脲
　　[中图分类号] R587.2 [文献标识码] A [文章编号] 1673-7210（2012）08（b）-0059-03
　　Efficacy observation of Detemir combined with Glimepiride on type 2 diabetes
　　MA Yiting1 PENG Yi2
　　1.The Commercial Hospital of Zhangjiakou City in Hebei Province, Zhangjiakou 075000, China; 2.The First Hospital of Zhangjiakou City in Hebei Province, Zhangjiakou 075000, China
　　[Abstract] Objective To explore the clinical efficacy of Detemir combined with Glimepiride in the treatment of type 2 diabetes. Methods 70 cases who were diagnosed as type 2 diabetes patients from March 2011 to March 2012 in our hospital were randomly divided into observation group and control group, with 35 cases in each group, the observation group were treated with Detemir (Det) combined with Glimepiride, the control group were treated with human insulin isophane (NPH) combined with Glimepiride, all patients were treated for 6 months, the weight, fasting blood glucose (FBG), 2-hour postprandial blood glucose (2 h PG), glycosylated hemoglobin (HbA1c), body mass index (BMI) change were monitored before and after treatment, the standard time of blood glucose, incidence of hypoglycemia and insulin dosage were recorded, islet B cell function (Homa-B) and insulin resistance (Homa-IR) were calculated. Results Before treatment, the differences of FBG, 2 h PG, HbA1c, BMI, Homa-B and Homa-IR between two groups were not statistically significant (P ＞ 0.05); after treatment, two groups of FBG, 2 h PG and HbA1c decreased significantly, the difference was statistically significant (P ＜ 0.05); the BMI of observation group decreased more than that of the control group, the difference was statistically significant (P ＜ 0.05). The standard time of blood glucose, incidence of hypoglycemia and insulin dosage were lower than those of the control group, the differences were statistically significant (P ＜ 0.01). Conclusion Compared with human insulin isophane, Detemir treatment of type 2 diabetes has notable efficacy, lower incidence of hypoglycemia, can betterly control the patient"s weight, the method is simple, safe and effective and is worthy of clinical application.