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目的:探讨精蛋白生物合成人胰岛素注射液(预混30R)(以下简称“诺和灵30R”)强化治疗对初发2型糖尿病患者血糖、糖化血红蛋白(HbA1c)及胰岛B细胞功能等的影响。方法:将68例2型糖尿病初发患者根据随机数字表法分为观察组和对照组,各34例。对照组患者口服阿卡波糖+格列美脲;观察组患者皮下注射诺和灵30R,根据血糖水平调整胰岛素注射剂量及次数。两组患者的血糖控制目标均为空腹血糖(FBG)3.9~7.2 mmol/L、餐后2 h血糖(2 hPG)7.8~10.0 mmol/L。比较两组患者的FBG、2 hPG、HbA1c、血糖达标时间、体质量指数(BMI)和胰岛B细胞功能。结果:治疗前,两组患者的FBG、2 hPG、HbA1c及BMI比较,差异均无统计学意义(P>0.05);治疗后,两组患者的FBG、2 hPG和HbA1c均较治疗前明显降低,且观察组明显低于对照组,血糖达标时间亦明显短于对照组,差异均有统计学意义(P<0.05);两组患者的BMI在治疗前后比较差异无统计学意义(P>0.05)。治疗前,两组患者的胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMA-B)、糖负荷后30 min胰岛素净增值与葡萄糖净增值的比值(I30/G30)比较,差异均无统计学意义(P>0.05);治疗后,两组患者的HOMA-IR较治疗前明显降低,HOMA-B和I30/G30较治疗前明显升高,且观察组患者的上述指标明显优于对照组,差异均有统计学意义(P<0.05)。两组患者均未见明显不良反应发生。结论:诺和灵30R强化治疗能够更为有效地降低初发2型糖尿病患者血糖和HbA1c水平,缩短血糖达标时间,改善胰岛B细胞功能,且安全性较好。
OBJECTIVE: To investigate the effects of intensive treatment of Isophane protamine biosynthetic human insulin injection (premix 30R, called “Novolin 30R” for short) on blood glucose, HbA1c and islet B cell function of patients with primary type 2 diabetes. METHODS: 68 patients with primary type 2 diabetes were divided into observation group and control group by random number table method, with 34 cases in each group. Control group received acarbose+glimepiride orally; observation group received Novolin 30R subcutaneously, and the dose and times of injection were adjusted according to blood glucose level. The target fasting blood glucose (FBG) and 2 h postprandial blood glucose (2 hPG) were 3.9-7.2 mmol/L and 7.8-10.0 mmol/L. FBG, 2 hPG, HbA1c, the time of blood glucose reaching the standard, BMI and islet B cell function were compared between 2 groups. RESULTS: FBG, 2 hPG, HbA1c and BMI of 2 groups had no statistical significance before treatment (P>0.05); compared to before treatment, FBG, 2 hPG and HbA1c of 2 groups were decreased significantly after treatment, and observation group were significantly lower than those of control group; the time of blood glucose reaching the standard was significantly shorter than control group, with statistical significance (P<0.05). There was no statistical significance in BMI between 2 groups before and after treatment (P>0.05). Before treatment, HOMA-IR, HOMA-B and I30/G30 of 2 groups had no statistical significance (P>0.05); compared to before treatment, HOMA-IR of 2 groups were decreased significantly, while HOMA-B and I30/G30 were increased significantly after treatment; the indexes of observation group was significantly better than that of control group with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS: Intensive treatment of Novolin 30R can effectively reduce blood glucose and HbA1c levels of patients with primary type 2 diabetes, shorten the time of blood glucose reaching standard and improve islet B cell function with good safety.
精蛋白生物合成人胰岛素注射液(预混30R)初发2型糖尿病强化治疗血糖糖化血红蛋白胰岛B细胞
Isophane protamine biosynthetic human insulin injection (premix 30R)Primary type 2 diabetesIntensive treatmentBlood glucoseGlycated hemoglobinIslet B cell
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