拜唐苹治疗优泌乐25中餐后血糖控制不佳患者的疗效研究

Effect of Acarbose on type 2 diabetes with inadequate glycemic control after lunch treated with Insulin Lispro Mix25

摘要:

观察拜唐苹中餐时顿服对使用优泌乐25 早、晚餐前注射的中餐后血糖控制不佳的2 型糖尿病患者的疗效。方法选取优泌乐25 早、晚餐前皮下注射，早、晚餐前血糖基本控制，但中餐后2 h 血糖控制不佳（>10 mmol/L）的2 型糖尿病患者86 例，随机分为两组：A组维持早、晚胰岛素剂量不变，中餐时增加拜唐苹1 次顿服，50～100 mg；B组维持早、晚胰岛素剂量不变，中餐前增加1 次优泌乐25（0.1～0.3 u/kg 体重）。2 周后比较7∶00 血糖谱（3 餐前、3 餐后2 h、睡前）变化及低血糖发生频率。结果①两组中餐后2 h血糖达标率比较：A 组为86.05%，B 组为88.37%，两组比较，差异无统计学意义（p >0.05）；②两组7∶00 血糖值比较：A 组晚餐后2 h 血糖（7.8±1.0）mmol/L，B 组（6.1±1.1）mmol/L，两组比较，差异有统计学意义（p <0.05），两组3 餐前、早餐后2 h、中餐后2 h、睡前血糖比较，差异无统计学意义；③低血糖反应：A 组为4.65%，B 组为18.60%，两组比较，差异有统计学意义（p <0.05）。结论采用优泌乐25 早、晚餐前皮下注射的中餐后2 h血糖控制不佳者，中餐时增加拜唐苹1 次顿服与中餐前增加1 次优泌乐25 注射，控制血糖疗效相当，低血糖风险减少。

Abstract:

To appraise the efficacy of Acarbose at lunch in treatment of type 2 diabetes with inadequate glycemic control after lunch treated with Insulin Lispro Mix25 before breakfast and supper. Methods Eighty-six cases with type 2 diabetes mellitus, who were treated with Insulin Lispro Mix25 Injection before breakfast and supper but still had inadequate glycemic control after lunch (> 10 mmol/L), were randomly divided into two groups. The patients in the group A were added with Acarbose 50-100 mg at lunch to improve post-prandial blood glucose. The patients in the group B were added with Insulin Lispro Mix25 Injection 0.1-0.3 u/kg before lunch to improve postprandial blood glucose. After 2 weeks, the changes of seven-point blood glucose spectrum (before three meals, 2 h after three meals, at bedtime) and the frequency of hypoglycemia were compared between the two groups. Results The rate of the patients reaching the standard level of postprandial 2-h blood glucose after lunch was not significantly different between the group A and the group B (86.05%vs 88.37%, p> 0.05). Comparison of the seven-point blood glucose spectra of the two groups showed that the postprandial 2-h blood glucose after supper in the group B was significantly lower than that in the group A[(6.1 ±1.1) mmol/L vs (7.8 ±1.0) mmol/L,p < 0.05], while the blood glucose levels at other time points were not different between the two groups. The frequency of hypoglycemia in the group A was significantly lower than that in the group B (4.65% vs 18.60%,p <0.05). Conclusions Application of Acarbose at lunch can effectively control the postprandial 2-h blood glucose after lunch, and decrease the frequency of hypoglycemia.