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目的采用动态血糖监测(CGMS)系统观察口服降糖药控制不佳的T2DM患者加用地特胰岛素治疗的优越性。方法 68例使用口服降糖药血糖控制不佳的T2DM患者,按1∶1随机分为睡前加用地特胰岛素组(Det组)和中性鱼精蛋白锌胰岛素组(NPH组),治疗12周。结果治疗12周后,两组HbA1c、FPG均较基线下降,但两组间差异无统计学意义(P>0.05)。Det组血糖值标准差、FPG标准差、睡前血糖标准差、日间血糖平均绝对差均明显低于NPH组(P<0.05,P<0.01)。Det组低血糖发生率(11.8%)显著低于NPH组(23.5%)(P<0.05)。结论使用口服降糖药血糖控制不佳的T2DM患者,联合地特胰岛素对比联合NPH治疗,在FPG和HbA1c同样达到较好控制的同时,经CGMS证实,地特胰岛素治疗一日内和一日间血糖波动小,低血糖发生率低。
Objective To observe the superiority of detemir treatment in T2DM patients with poorly controlled oral hypoglycemic agents by dynamic blood glucose monitoring (CGMS) system. Methods A total of 68 patients with T2DM with poor glycemic control by oral hypoglycemic agents were randomly divided into treatment group (Det group) and neutral protamine zinc insulin group (NPH group) week. Results After 12 weeks of treatment, HbA1c and FPG in both groups decreased from baseline, but there was no significant difference between the two groups (P> 0.05). The standard deviation of blood glucose, standard deviation of FPG, standard deviation of blood glucose before going to sleep, and average absolute difference of blood glucose during day were significantly lower in Det group than those in NPH group (P <0.05, P <0.01). The incidence of hypoglycemia in the Det group (11.8%) was significantly lower than that in the NPH group (23.5%) (P <0.05). Conclusions In patients with T2DM with poor glycemic control by oral hypoglycemic agents, in combination with insulin de novo insulin and NPH, FPG and HbA1c also achieve better control. CGMS confirmed that insulin detemir treatment within one day and daytime blood glucose Small fluctuations, low incidence of hypoglycemia.