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将24例脆性糖尿病患者随机分为应用阿卡波糖联合甘精胰岛素治疗(对照组)12例、应用甘精胰岛素联合甘舒霖R治疗(治疗组)12例,观察两组患者治疗后两周内低血糖相关指标和其他血糖波动参数,包括低血糖发生率(PT3.9,即血糖低于3.9 mmol/L的时间比)、低血糖发生次数、高血糖发生率(PT7.8、PT11.1,即血糖高于7.8 mmol/L或11.1mmol/L的时间比)、血糖波动系数(即连续测定的血糖值标准差,SDBG)最大血糖波动幅度(LAGE)和平均血糖波动幅度(MAGE),3月后比较两组患者上述参数及糖化血红蛋白的水平。结果对照组PT7.8[(21.85±11.43)%]、PT11.1[(35.54±12.1)%]、SDBG(4.34±0.94)、LAGE[(13.21±1.82)mmol/L]、MAGE[(10.5±1.37)mmol/L]和HbA_(1C)(%)[(8.5.±2.1)%]等指标均高于治疗组(54.56±12.56)%、(19.45±10.5)%、(2.81±1.12)、(10.13±2.31)mmol/L、(7.4±1.45)mmol/L]、[(6.4±1.1)%]的糖尿病患者。差异均有高度统计学意义(均P<0.01)。对照组的PT3.9[(10.13±2.4)%]和治疗组的[(12.57±3.5)%]结果相似,无统计学意义(P>0.05)。结论甘精胰岛素联合阿卡波糖难以平稳控制脆性糖尿病患者血糖水平,应用甘精胰岛素联合甘舒霖R可以有效控制全天血糖。
Twenty-four patients with fragile diabetes were randomly divided into 12 cases treated with acarbose combined with insulin glargine (control group), 12 cases treated with glargine and Gansuolin R (treatment group), and two groups were observed within two weeks after treatment Hypoglycaemia related parameters and other parameters of blood glucose fluctuation, including the incidence of hypoglycaemia (PT3.9, the time ratio of blood glucose less than 3.9 mmol / L), the incidence of hypoglycemia, the incidence of hyperglycemia (PT7.8, PT11.1 , That is, the time ratio of blood glucose higher than 7.8 mmol / L or 11.1 mmol / L), blood glucose fluctuation coefficient (SDBG), maximum blood glucose fluctuation (LAGE) and average blood glucose fluctuation (MAGE) After 3 months, the above parameters and the level of HbA1c in the two groups were compared. Results Compared with control group, PT7.8 [(21.85 ± 11.43)%], PT11.1 (35.54 ± 12.1)%, SDBG (4.34 ± 0.94), LAGE [(13.21 ± 1.82) mmol / L] ± 1.37 mmol / L] and HbA 1C (%) [(8.5 ± 2.1)%] were higher than those in the treatment group (54.56 ± 12.56)%, (19.45 ± 10.5)% and (2.81 ± 1.12) , (10.13 ± 2.31) mmol / L, (7.4 ± 1.45) mmol / L] and [(6.4 ± 1.1)%] respectively. The differences were highly statistically significant (all P <0.01). The results of PT3.9 [(10.13 ± 2.4)%] in the control group were similar to those in the treatment group (12.57 ± 3.5%). There was no statistical significance (P> 0.05). Conclusion Glargine combined with acarbose is difficult to control the blood sugar level in patients with fragile diabetes smoothly. Glargine and Gansu lin R can effectively control the blood sugar in the whole day.