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目的观察甘精胰岛素在初诊2型糖尿病短期强化治疗后的临床应用。方法选择68例强化治疗后血糖控制不理想的新诊断2型糖尿病患者,将其随机分成两组,甘精胰岛素组(35例)每日1次皮下注射,预混胰岛素(诺和灵30R)组(33例)每日2次皮下注射。观察两组患者的血糖控制情况,12周后观察两组患者糖化血红蛋白及C肽水平变化。结果两组患者血糖均明显下降,甘精胰岛素组空腹血糖下降幅度明显大于预混组(P<0.05);两组的胰岛功能均得到明显恢复,但差异无统计学意义(P>0.05)。甘精胰岛素组低血糖发生率明显低于对照组(P<0.05),甘精胰岛素组的胰岛素用量及体质量增加值低于预混组(P<0.05)。结论对短期强化治疗后新诊断2型糖尿病血糖控制不理想患者,应用甘精胰岛素或预混胰岛素进行治疗,均能达到明显的降糖效果,使胰岛功能得到明显恢复。其中甘精胰岛素降低空腹血糖效果更好,胰岛素用量较少,夜间低血糖发生率低,应用方便、安全、有效,患者依从性好,是值得临床应用推广。
Objective To observe the clinical application of insulin glargine after short-term intensive treatment of newly diagnosed type 2 diabetes mellitus. Methods Sixty-eight patients with newly diagnosed type 2 diabetes who did not control their glycemic control after intensive therapy were randomly divided into two groups. The insulin glargine group (n = 35) was injected subcutaneously once daily (norepinephrine 30R) Group (33 cases) twice daily subcutaneous injection. The glycemic control was observed in both groups. After 12 weeks, the changes of HbA1c and C-peptide levels in both groups were observed. Results The blood glucose of the two groups were significantly decreased, while the fasting blood glucose of insulin glargine decreased significantly more than that of the premixed group (P <0.05). The islet function of both groups recovered obviously, but the difference was not statistically significant (P> 0.05). The incidence of hypoglycemia in insulin glargine group was significantly lower than that in control group (P <0.05). Insulin dosage and body weight gain in insulin glargine group were lower than those in control group (P <0.05). Conclusions The patients with newly diagnosed type 2 diabetes who did not control glycemic control after short-term intensive therapy were treated with insulin glargine or premixed insulin, which could achieve significant hypoglycemic effect and significantly restore the islet function. Which glargine to reduce fasting blood glucose better, less insulin dosage, low incidence of hypoglycemia at night, the application of convenient, safe and effective, patient compliance, is worthy of clinical application.