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目的评价甘精胰岛素联合预混胰岛素疗法治疗2型糖尿病的临床疗效及其对血浆氧化低密度脂蛋白(OX-LDL)的影响。方法将80例预混胰岛素血糖控制不良T2DM患者分为观察组40例(原预混胰岛素及甘精胰岛素早餐前同时注射)与对照组40例(在原方案基础上调整剂量)。两组均予阿卡波糖片100 mg每晚餐中口服及二甲双胍片0.5 g三餐后口服,同时根据血糖调整各组胰岛素用量。治疗12周后比较两组患者的空腹血糖(FBG)、3餐后2 h血糖(2h PG)、糖化血红蛋白(Hb A1c)、体质量指数(BMI)、日胰岛素剂量、低血糖事件及血浆OX-LDL。结果与治疗前相比,观察组及对照组治疗后的FBG、三餐2 h PG、晚餐前血糖、日血糖差值、Hb A1c、OX-LDL均下降(均<0.05);治疗后对照组日胰岛素剂量及BMI明显增加(均<0.05),而观察组无改变;与对照组相比,观察组的FBG、3餐后2 h PG、晚餐前血糖、日血糖差值,Hb A1c、日胰岛素剂量、低血糖事件及OX-LDL均下降(均<0.05)。结论用预混胰岛素控制血糖欠佳的T2DM患者,改为早餐前甘精和预混胰岛素注射治疗,在改善血糖谱及低血糖风险的同时,能降低血浆OX-LDL水平,一定程度上延缓糖尿病患者动脉硬化进展。
Objective To evaluate the clinical efficacy of insulin glargine and premixed insulin in the treatment of type 2 diabetes mellitus (T2DM) and its effect on plasma oxidized low density lipoprotein (OX-LDL). Methods Eighty patients with dysglycemic control of preeclampsia were divided into the observation group (40 cases) and the control group (40 cases). The control group received 40 doses of insulin and glargine at the same time. Both groups were given acarbose 100 mg per meal of oral and metformin tablets 0.5 g after three meals orally, at the same time according to the blood glucose to adjust the amount of insulin in each group. After 12 weeks of treatment, fasting blood glucose (FBG), 2h PG, Hb A1c, BMI, daily insulin dose, hypoglycemia and plasma OX -LDL. Results Compared with those before treatment, FBG, PG at 3 meals, PG before meals, blood glucose difference, Hb A1c and OX-LDL both decreased in the observation group and the control group (all P <0.05) Daily insulin dose and BMI were significantly increased (all <0.05), while the observation group had no change; compared with the control group, the observation group FBG, 3 postprandial 2 h PG, before dinner blood glucose, blood glucose difference, Hb A1c, Insulin dose, hypoglycemic events and OX-LDL decreased (all <0.05). Conclusions The premixed insulin is used to control T2DM patients with poor blood glucose and replaced with Ganoderma lucidum and premixed insulin injection before breakfast, which can reduce the plasma OX-LDL level and improve the diabetes mellitus to a certain extent while improving the blood glucose and hypoglycemia risk Patients with atherosclerosis progress.