摘要
目的探讨口服降糖药物血糖控制不佳患者加用降糖药或胰岛素的临床疗效,及对抑郁情绪的影响。方法将52例口服降糖药物血糖控制不佳的2型糖尿病(T2DM)患者随机分为两组,分别加用地特胰岛素(胰岛素组,26例)和另一种降糖药(降糖药组,26例)。比较两组患者血糖指标的变化、血糖波动、抑郁情绪及不良事件的发生情况。结果治疗后,两组的FBG、2h PG及Hb A1c水平均明显下降,而胰岛素组的Hb A1c水平显著低于降糖药组(t=-4.23,P<0.05),两组治疗后FBG、2h PG比较,差异无统计学意义(t=-0.99,-0.63,P>0.05);胰岛素组的MBG、MAGE均显著低于降糖药组(t=4.83,-4.05,P<0.05);治疗后,胰岛素组抑郁患者SDS评分显著下降(t=2.83,P<0.05),且明显低于降糖药组抑郁患者(t=-2.76,P<0.05);胰岛素组低血糖、症状性低血糖的总发生率较降糖药组显著降低(χ2=-4.28,P<0.05)。结论对口服单一降糖药血糖控制不佳的T2DM患者,联合基础胰岛素或另一种降糖药均能有效控制血糖,但前者可改善抑郁症状,且血糖波动小,低血糖发生率低。
Objective To explore the efficacy of additional insulin or antidiabetic drug in poorly controlled type 2 diabetes（T2DM） with one antidiabetic drug, and its influence on depression. Methods A total of 52 eases of poorly controlled T2DM with one antidiabetic drug were divided into two groups, which were given detemir （ insulin group, 26 cases） and another antidiabetic drug（ antidiabetic drug group, 26 cases）. The changes in blood sugar, blood sugar fluctuation, depression and the occurrence of adverse events were compared and analyzed between the two groups. Results After treatment, the level of FBG, 2hPG, and HbAlc in both groups were all reduced, the level of HbA1 e in insulin group was significantly lower than that in antidiabetic drug group（ t = -4.23,P 〈 0.05 ） ,while there was no significant difference in the level of FBG, 2hPG（ t = -0.99, -0.63 ,P 〉0. 05 ）. The level of MBG, MAGE in insulin group were signifi- cantly lower than those in antidiabetic drug group（t = 4.83, - 4.05 ,P 〈 0.05）. After treatment, the SDS score in depression patients of insulin group was significantly reduced（ t = 2.86 ,P 〈 0.05 ） , and lower than that in the depression patients of antidiabetic drug group （ t = -2.76 ,P 〈 0.05 ）. The MBG, MAGE in insulin group were significantly lower than those in antidiabetic drug group （χ2 = -4.28,P 〈 0. 05）. Compared with antidiabetie drug group, the incidence of hypoglycemia and symptomatic hypoglycemia in insulin group were signif- icantly reduced （P 〈 0.05）. Conclusions Combination use of basal insulin or antidiabetic drug for poorly controlled T2DM with one an- tidiabetic drug can effectively control blood sugar, but insulin detemir can improve the depression symptom, has lower blood glucose fluc- tuation, and incidence of hypoglycemia.
出处
《医学研究杂志》
2015年第11期115-117,共3页
Journal of Medical Research
关键词
2型糖尿病
降糖药
胰岛素
血糖控制
抑郁
Type 2 diabetes
Antidiabetic drug
Insulin
Glycemic control
Depression
