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目的:评价地特胰岛素、甘精胰岛素和门冬胰岛素30注射液治疗老年2型糖尿病(T2DM)的疗效对比。方法:246例老年T2DM患者随机分为地特胰岛素组(Det组)、甘精胰岛素组(Gla组)和门冬胰岛素30注射液组(Pre组),比较3组治疗前后FBG、2hBG、HbAlc、空腹C肽(FC-P)及100g馒头餐后2hC肽(2hC-P)水平、体重变化、低血糖发生率及患者依从性。结果:治疗后三组FBG、2hBG、HbAlc水平均较治疗前显著降低(P<0.01),Det、Gla组FBG、HbAlc水平显著低于Pre组(P<0.05),Pre组2hC-P水平较治疗前显著增加(P<0.05)。Det、Gla组体重增加、低血糖发生率显著低于Pre组(P<0.05或0.01),且相较于Gla组,Det组体重增加明显减少(P<0.01)。结论:基层老年T2DM患者口服降糖药失效时,联合应用地特胰岛素是较优的治疗方案。
OBJECTIVE: To evaluate the efficacy of insulin detemir, insulin glargine and insulin aspart 30 in the treatment of type 2 diabetes in the elderly (T2DM). Methods: A total of 246 elderly patients with T2DM were randomly divided into Detmin, Gla, and As groups. The levels of FBG, 2hBG, HbA1c , Fasting C-peptide (FC-P) and 100g steamed bread 2hC peptide (2hC-P) level, body weight changes, the incidence of hypoglycemia and patient compliance. Results: The levels of FBG, HbAlc, FBG and HbAlc in the three groups after treatment were significantly lower than those before treatment (P <0.01). The levels of FBG and HbAlc in Det and Gla were significantly lower than those in Pre group (P <0.05) Before treatment, there was a significant increase (P <0.05). Body weight increased and the incidence of hypoglycemia in Det and Gla groups was significantly lower than that in Pre group (P <0.05 or 0.01). The weight gain in Det group was significantly lower than that in Gla group (P <0.01). Conclusion: The combination of insulin detemir and insulin dextran is an effective treatment for elderly patients with T2DM due to the failure of oral hypoglycemic agents.