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目的探讨在服用降糖药治疗的T2DM患者中,每天加用一次地特胰岛素治疗的临床疗效及安全性。方法单纯口服降糖药治疗、血糖控制不佳的T2DM患者36例,对照组在口服药基础上加用中效胰岛素,治疗组在其口服药基础上加用每日一次地特胰岛素,就寝前注射,比较治疗前、治疗后12周、24周空腹血糖、HbA_1 c、血脂、血压、BMI变化,记录低血糖发生率。结果两组治疗后12、24周患者空腹血糖、HbA_1c较治疗前均明显降低(P<0.05);治疗后12、24周两组间空腹血糖、HbA_1c差异无统计学意义;地特胰岛素组低血糖发生率明显低于对照组(P<0.01);地特胰岛素组治疗24周后体重增加0.39kg,中效胰岛素组增加0.88kg,两组间差异无统计学意义。结论口服药物联合地特胰岛素能更有效控制血糖,低血糖发生率少,体重增加不明显。
Objective To investigate the clinical efficacy and safety of insulin detemir once a day in T2DM patients taking hypoglycemic agents. Methods A total of 36 patients with T2DM undergoing oral hypoglycemic agents and poor glycemic control were enrolled in this study. The control group was given middle-acting insulin on the basis of oral drug. The treatment group was given insulin once daily on the basis of oral drug. The levels of fasting blood glucose, HbA 1 c, blood lipids, blood pressure and BMI were compared before and 12 weeks after treatment, and the incidence of hypoglycemia was recorded. Results The fasting blood glucose and HbA 1c in both groups after 12 and 24 weeks of treatment were significantly lower than those before treatment (P <0.05). There was no significant difference in fasting blood glucose and HbA 1c between the two groups 12 and 24 weeks after treatment The incidence of blood glucose was significantly lower than that of the control group (P <0.01). The weight gain was 0.39 kg in the insulin detemir group after treatment for 24 weeks and 0.88 kg in the middle-acting insulin group. There was no significant difference between the two groups. Conclusion Oral drugs combined with insulin detemir can more effectively control blood sugar, low incidence of hypoglycemia, weight gain is not obvious.