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目的 比较速效胰岛素类似物 (诺和锐 )和短效人胰岛素 (诺和灵R)用外置的胰岛素泵持续皮下输注 (CSⅡ )治疗 2型糖尿病 (T2DM )的疗效。 方法 该研究为持续 2 4周随机、开放、交叉实验 ,2 9例T2DM患者 ,随机分为诺和锐组和诺和灵R组 ,诺和锐为餐前即刻输注 ,诺和灵R为餐前 30min输注 ,12周治疗后两组交换用药。观察两种不同治疗方式患者糖化血红蛋白 (HbA1c)、8个时点 (3餐前后、睡前、凌晨 2点 )血糖、低血糖及胰岛素泵的安全性的差异。 结果 接受诺和锐治疗组的患者HbA1c指标好于诺和灵R组 (P <0 0 1)。 8个时点血糖检测显示诺和锐组三餐后及睡前血糖水平均低于诺和灵R组 (P <0 0 1～ 0 0 5 )。两组患者胰岛素用量、低血糖发生率及胰岛素泵的安全性均无差异。 结论 诺和锐与诺和灵R均可安全有效的降低血糖及HbA1c ,诺和锐用于CSⅡ控制餐后血糖更具优点。
Objective To compare the efficacy of fast-acting insulin analogue (Novo-sharp) and short-acting human insulin (Novo Spirit R) with type 2 diabetes mellitus (T2DM) treated with an external insulin pump for continuous subcutaneous infusion (CSII). METHODS: Twenty-nine patients with T2DM who were randomized, open and crossed for 24 weeks were randomized into Novolin and Novolin D group. Novolin was infused immediately before meals and Novolin R 30min infusion before meals, 12 weeks after treatment, two groups exchange medication. HbA1c was observed in two different treatment modalities. The differences in the safety of blood glucose, hypoglycemia and insulin pump at 8 time points (before and after 3 meals, before going to bed, at 2:00 am) were observed. Results The HbA1c level in patients receiving Nuo-Rui-Rui treatment group was better than that in Novolin group (P <0.01). Blood glucose test at 8 points showed that the blood glucose level of Novo and Rui group was lower than that of Noropenem group (P <0.01 ~ 0.05). There was no difference in insulin dosage, incidence of hypoglycaemia, and insulin pump safety in both groups. Conclusions Nuo-ning rui and norepinephrine are safe and effective in reducing blood glucose and HbA1c, Nuo-Rui and CSII for postprandial blood glucose control more advantages.