【摘要】 目的 对比分析胰岛素类似物赖脯胰岛素75/25和人胰岛素优泌林70/30治疗2型糖尿病对血糖的控制作用和安全性。 方法 选取2007年6月-2008年7月107例2型糖尿病患者,随机分为两组:赖脯胰岛素75/25组54例,每日早、晚餐前10 min皮下注射赖脯胰岛素75/25,剂量0.5~0.7 U/(kg•d);优泌林70/30组53例,每日早、晚餐前30 min注射优泌林70/30,剂量0.7~1.0 U /(kg•d),治疗2周后观察患者日胰岛素总量、血糖控制情况、体质量及低血糖发生率。 结果 治疗2周后,赖脯胰岛素75/25组FBG由(15.4±3.1) mmol/L降为(6.5±1.4) mmol/L(P lt;0.05)、PBG-2h由(22.2±6.5) mmol/L降至(9.23±2.51) mmol/L(P lt;0.05);优泌林70/30组FBG由(14.9±3.0) mmol/L降为(6.7±1.7) mmol/L(P lt;0.05),PBG-2h由(21.7±7.3) mmol/L降至(11.10±2.73) mmol/L(P lt;0.05)。治疗3个月后赖脯胰岛素75/25组HbA1c水平明显下降,与优泌林70/30组比较差异有统计学意义(P lt;0.05);日胰岛素用量赖脯胰岛素75/25组较优泌林70/30组低(P lt;0.05),体质量变化及低血糖发生率两组比较无统计差异性(P gt;0.05)。 结论 赖脯胰岛素75/25治疗2型糖尿病,HbA1c水平更低,达标患者的比例更高,具有良好的安全性及依从性。
【Abstract】 Objective To compare the clinical safety and effect of insulin analogues insulin lispro 75/25 and human insulin humulin 70/30 on type 2 diabetes mellitus. Methods A total of 107 patients with type 2 diabetes mellitus from June 2007 to July 2008 were randomly divided into two groups: 54 patients in group A were injected with insulin lispro 75/25 [0.5-0.7 U/(kg•d)], twice per day, 10 minutes before each breakfast and dinner, and another 53 patients in group B were injected with human insulin humulin 70/30 [0.7-1.0 U/(kg•d)], twice per day, 30 minutes before each breakfast and dinner. The daily insulin dosage, level of blood glucose, body mass and the incidence of low blood sugar in the two groups were observed. Results Two weeks after the treatment, the level of FBG decreased from (15.4±3.1) mmol/L to (6.5±1.4) mmol/L (P lt;0.05), and the level of PBG-2h decreased from (22.2±6.5) mmol/L to (9.23±2.51) mmol/L (P lt;0.05) in group A; the level of FBG decreased from (14.9±3.0) mmol/L to (6.7±1.7) mmol/L (P lt;0.05), and the level of PBG-2h decreased from (21.7±7.3) mmol/L to (11.10±2.73) mmol/L (P lt;0.05) in group B. Three months after the treatment, the level of HbA1c in group A decreased apparently, which differed much from that in group B (P lt;0.05). The daily dosage of insulin in group A was lower than that in group B (P lt;0.05); the differences in changes of body mass and the incidence of hypoglycemia between the two groups were not significant (P gt;0.05). Conclusion The treatment with insulin lispro 75/25 for type 2 diabetes mellitus shows a good effect on HbA1c level control with safety and compliance.
Citation:
DU Xiaomei. Comparison of Efficacy of Insulin Lispro 75/25 and Human Insulin Humulin 70/30 on Type 2 Diabetes Mellitus. West China Medical Journal, 2010, 25(11): 2012-2014. doi:
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Stratton IM, Adler AI, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes: prospective observational study[J]. BMJ, 2000, 321(8): 405-412.
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Roach P, Trautmann M, Arora V, et al. Improved postprandial blood glucose control and reduced nocturnal hypoglycemia during treatment with two novel insulin lispro-protamine formulations, inslin lispro mix25 and insulin lispro mixso[J]. Clin Ther, 1999, 21(9): 523-534.
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- 1. Weyer C, Heise T, Heinemann L. Insulin aspart in a 30/70 premixed formulation. Pharmacodynamic properties of a rapid-acting insulin analog in stable mixture[J]. Diabetes Care, 1997, 20(6): 1612-1614.
- 2. Anderson JH Jr, Brunelle RL, Koivisto VA, et al. Reduction of postprandial hyperglycemia and frequency of hypoglycemia in IDDM patients on insulin-analog treatment. Multicenter Insulin Lispro Study Group[J]. Diabetes, 1997, 46(4): 265-270.
- 3. 钱荣立. 糖尿病临床指南[M]. 北京: 北京医科大学出版社, 2000: 7-12.
- 4. UK Prospective Diabetes Study Group. Quality of life in type 2 diabetes patients is effected by complications but not by intensive policies to improve blood glucuse or pressure control(UKPDS)[J]. Diabetes Care, 1999, 22(5): 1125.
- 5. Malone JK, Wolthers T, Sun B, et al. Improvement in HbAlc in patients with type 2 diabetes with Humalog Mix 25 versus basal human insulin: a double-blind study[J]. J Appl Ther Res, 2004, 4(5): 19-25.
- 6. 叶任高, 陆再英. 内科学[M]. 6版. 北京: 人民卫生出版社, 2006: 815-820.
- 7. Reviriego J, Herz M, Roach P, et al. Improved glycadmic control without increased risk of hypoglycaemia with a 25% insulin/lispro75% NPL mixture twice daily compared with NPH twice daily in patients with type2 diabetes[J]. J Appl Ther Res, 2004, 4(6): 3-9.
- 8. Stratton IM, Adler AI, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes: prospective observational study[J]. BMJ, 2000, 321(8): 405-412.
- 9. Overmann H, Heinemann L. Injection-meal interval: recommendations of diabetologists and how patients handle it[J]. Diabetes Res Clin Pract, 1999, 43(2): 137-142.
- 10. 王金抒. 老年糖尿病131例临床分析[J]. 华西医学, 1995, 10(4): 121-123.
- 11. Roach P, Trautmann M, Arora V, et al. Improved postprandial blood glucose control and reduced nocturnal hypoglycemia during treatment with two novel insulin lispro-protamine formulations, inslin lispro mix25 and insulin lispro mixso[J]. Clin Ther, 1999, 21(9): 523-534.