摘要
目的观察地特胰岛素联合瑞格列奈治疗对老年糖尿病患者血糖控制及体质量指数(BMI)的影响。方法选取四川大学华西医院2017年8月-2019年8月收治的老年糖尿病患者100例,根据数字表法随机分为2组:观察组和对照组,每组50例。对照组患者给予瑞格列奈治疗,观察组给予地特胰岛素联合瑞格列奈治疗。评估并比较2组治疗前后血糖变化,包括空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbAlc)、24 h平均血糖(MBG)、1日内平均血糖波动幅度(MAGE),分析空腹胰岛素(FINS)、餐后2 h胰岛素(2 h PINS)、空腹C肽(FCP)、餐后2h C肽(2 h PCP)、胰岛素抵抗指数(HOMA-IR)及胰岛细胞功能指数(HOMA-)指标的变化,以及BMI变化及治疗期间患者低血糖发生率。结果治疗后,观察组FPG、2 h PG、MBG和MAGE均显著低于对照组(P<0.05);观察组FINS、2 h FINS、FCP和2 h PCP均显著高于对照组(P<0.05);观察组HOMA-显著高于对照组,HOMA-IR显著低于对照组(P<0.05)。治疗前后2组BMI比较差异无统计学意义(P>0.05);2组治疗期间低血糖发生率比较差异无统计学意义(8.00%vs 4.00%,P>0.05)。结论老年糖尿病患者采用地特胰岛素联合瑞格列奈治疗可有效控制血糖,改善胰岛素抵抗及胰岛细胞功能,且短期使用不导致BMI增加。
Objective To observe the effects of insulin detemir and repaglinide on blood glucose control and body mass index(BMI) of senile patients with diabetes. Methods 100 senile patients with diabetes admitted to our hospital from August2017 to August 2019 were selected and divided randomly into the observation group and the control group, with 50 ones in each group. Patients in the control group were treated with repaglinide, while those in the observation group were treated with insulin detemir combined with repaglinide. Changes of blood glucose before and after treatment were monitored and compared between both groups, including fasting blood glucose(FBG), postprandial 2h plasma glucose(2h PG), glycosylated hemoglobin(HbAlc), 24h mean blood glucose(MBG) and 24h mean amplitude of glycemic excursions(MAGE);the changes of fasting insulin(FINS)), postprandial 2h insulin(2hPINS), fasting C-peptide(FCP), postprandial 2h C peptide(2h PCP), insulin resistance index(HOMA-IR) and islet-cell function index(HOMA-) of both groups were analyzed;the changes of BMI before and after the treatment and the incidence of hypoglycemia were compared between both groups. Results After treatment,the FPG, 2h PG, MBG and MAGE were significantly lower and the FINS, 2hFINS, FCP and 2hPCP in the observation group were significantly higher than those in the control group(P<0.05). After treatment, HOMA-in the observation group was significantly higher and the HOMA-IR was significantly lower than those in the control group(P<0.05). There was no significant difference in the BMI between the two groups before and after treatment(P>0.05). There was no significant difference in the incidence of hypoglycemia between the two groups(8.00% vs 4.00%)(P>0.05). Conclusions The combined treatment of insulin detemir and repaglinide for senile patients with diabetes can effectively control blood glucose, improve insulin resistance and islet-cell function, and does not lead to an increase of BMI in the short-term.
作者
林雪皎
吴小艾
Lin Xuejiao;Wu Xiaoai(Department of Nuclear Medicine,West China Hospital,Sichuan University,Chengdu,Sichuan,610041,P.R.China)
出处
《老年医学与保健》
CAS
2020年第2期250-253,共4页
Geriatrics & Health Care
基金
四川省科技计划项目(2017JY0324)。
