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目的比较口服降糖药(OAD)血糖控制不佳的老年T2DM患者,加用地特胰岛素、甘精胰岛素或中性鱼精蛋白锌胰岛素(NPH)治疗的有效性和安全性。方法 114例OAD血糖控制不佳的老年T2DM患者随机分为三组,分别加用地特胰岛素(Det组)、甘精胰岛素(Gla组)或NPH(NPH组),治疗24周。结果治疗24周后,三组HbA1c、FBG和2hBG均较基线下降,但三组间差异无统计学意义(P>0.05);胰岛素用量在三组间无统计学差异(P>0.05);Det组体重增加较Gla组和NPH组更少(P<0.05或P<0.01);Det组及Gla组低血糖发生率为0.9%,较NPH组的5.3%更低(P<0.01)。结论 OAD血糖控制不佳的老年T2DM患者,加用地特胰岛素、甘精胰岛素或NPH均可有效控制血糖,但地特胰岛素在减少体重增加及低血糖发生上更有优势。
Objective To compare the efficacy and safety of insulin detemir, insulin glargine or neutral protamine zinc insulin (NPH) in elderly patients with poorly controlled glycemic control oral glucose tolerance (OAD). Methods A total of 114 elderly T2DM patients with poorly controlled OAD glycemic control were randomly divided into three groups, treated with detemir (Det group), insulin glargine (Gla group), or NPH (NPH group) for 24 weeks. Results After treatment for 24 weeks, the levels of HbA1c, FBG and 2hBG in three groups decreased from baseline, but there was no significant difference among the three groups (P> 0.05). There was no significant difference in insulin dosage between the three groups (P> 0.05) The body weight gain was less than that of Gla and NPH groups (P <0.05 or P <0.01). The incidence of hypoglycemia in Det and Gla groups was 0.9%, which was lower than that of NPH group (P <0.01). Conclusions Elderly T2DM patients with poorly controlled blood glucose control of OAD can effectively control blood glucose by using insulin detemir, insulin glargine or NPH. However, insulin detemir is more effective in reducing weight gain and hypoglycemia.