本文關(guān)鍵詞： 地特胰島素 甘精胰島素 門冬胰島素30 2型糖尿病　出處：《重慶醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的觀察臨床三種常用的胰島素類似物在經(jīng)生活方式干預(yù)及口服藥物仍降糖效果不佳的2型糖尿病(T2DM)中啟用,并繼續(xù)聯(lián)合口服降糖藥物(OADs)的有效性及安全性,為臨床T2DM的胰島素起始治療方案選擇提供更多依據(jù)。方法入選受試者為經(jīng)生活方式干預(yù)及口服藥物仍降糖效果不佳的T2DM患者,共為：79例,分為3組,一組25人,給予加用地特胰島素；一組納入29人,給予加用甘精胰島素；一組25人,給予門冬胰島素30(BIAsp30)治療,每組聯(lián)合口服降糖藥(OADs),治療時間為4個月。測量治療前后患者的空腹血糖(FBG)、餐后血糖(PBG)、糖化血紅蛋白(HbAlc)、體重指數(shù)(BMI),計算出三組FBG、PBG、HbAlc的變化差值,并統(tǒng)計出HbAlc的達標(biāo)比率(HbAlc達標(biāo)判斷標(biāo)準(zhǔn)為7%)和低血糖發(fā)生率。結(jié)果治療前各組HbAlc、血糖測量值無顯著差異(P0.05)。經(jīng)4個月治療,三組HbAlc 、FBG、PBG均較入組前明顯下降(P0.01),組間下降幅度無顯著差異(P0.05)。3組治療前后BMI無顯著變化(P0.05)。地特胰島素組、甘精胰島素組、BIAsp30組HbAlc達標(biāo)率分別為44%、60%、53%,各組無顯著差異(P0.05)。地特胰島素組、甘精胰島素組、BIAsp30組低血糖發(fā)生率分別為12%、7%、20%,3組低血糖發(fā)生率比較無顯著差異(P0.05),無嚴重低血糖發(fā)生。結(jié)論經(jīng)生活方式干預(yù)及口服藥物仍降糖效果不佳的T2DM患者,在分別聯(lián)合上述三種胰島素類似物后,可達到相同的血糖控制效果,體重?zé)o明顯改變、低血糖發(fā)生率低。
[Abstract]:Objective to observe the use of three common insulin analogues in type 2 diabetes mellitus (T2DM), which were treated by lifestyle intervention and oral administration. The efficacy and safety of combined oral hypoglycemic drug OADswere also continued. Methods 79 patients with T2DM were enrolled in this study. They were divided into 3 groups, 25 persons in each group were treated with gatite insulin; A group of 29 people were given plus insulin glargine; A group of 25 people were treated with insulin asparagus 30 BIAsp30 (each group combined with oral hypoglycemic drug OADs). The duration of treatment was 4 months. Fasting blood glucose (FBGG), postprandial blood glucose (PBGG), glycosylated hemoglobin (HbAlcn) and body mass index (BMI) were measured before and after treatment. The variation difference of HbAlc in three groups of FBGN PBGN was calculated. The rate of meeting the standard of HbAlc and the incidence of hypoglycemia were found to be 7% and 7% respectively. Results before treatment, the rate of HbAlc in each group was determined. There was no significant difference in blood glucose measurement value (P 0.05). After 4 months of treatment, the levels of HbAlc in the three groups were significantly lower than those before entering the group (P 0.01). There was no significant difference in the decrease of BMI between the two groups. There was no significant change in BMI before and after treatment in P0.050.The insulin group and the insulin glargine group had no significant change before and after treatment. The rate of reaching the standard of HbAlc in the BIAsp30 group was 440.60 and 553, respectively. There was no significant difference between the three groups (P0.050.The insulin group and insulin glargine group). The incidence of hypoglycemia in the BIAsp30 group was 12 / 7 and 20 / 20 respectively. There was no significant difference in the hypoglycemia rate among the three groups (P0.05). There is no serious hypoglycemia. Conclusion the patients with T2DM who still have poor hypoglycemic effect after lifestyle intervention and oral administration can achieve the same blood glucose control effect after the combination of the three insulin analogs mentioned above. There was no significant change in body weight and low incidence of hypoglycemia.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R587.1

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