德谷门冬双胰岛素与德谷胰岛素在治疗胰岛功能较差的2型糖尿病患者中的效果比较
Comparison of the Efficacy of Insulin Degludec versus Insulin Degludec/Insulin Aspart on Treatment of Type 2 Diabetes Mellitus Patients with Poor Islet Function

目的：比较德谷门冬双胰岛素与德谷胰岛素分别联合门冬胰岛素在治疗胰岛功能较差的2型糖尿病(Type 2 diabetes mellitus, T2DM)患者的临床效果。方法：选取2020年6月~2021年10月潍坊医学院附属医院收治的40例胰岛功能较差的2型糖尿病患者，根据治疗方案不同分为德谷组和德谷门冬组各20例，德谷组给予早、中、晚餐前各1针门冬胰岛素 + 睡前1针德谷胰岛素皮下注射，德谷门冬组给予早、晚餐前各1针德谷门冬胰岛素 + 午餐前1针门冬胰岛素皮下注射。比较两组患者治疗6个月后，患者血糖指标[空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)、血清C肽(C-P)、低血糖发生率]的变化情况。结果：治疗后，两组FPG、2hPG、HbA1c均低于治疗前，差异极具有统计学意义(P < 0.001)，C-P高于治疗前，差异极具有统计学意义(P < 0.001)；两组间2hPG和HbA1c比较，差异有统计学意义(P < 0.05)，两组间FPG、C-P及低血糖发生率比较，差异无统计学意义(P > 0.05)。结论：两组均有较强的降糖效果，且糖化水平及胰岛功能均有所改善；但德谷组降低2hPG、HbA1c水平优于德谷门冬组，两组间FPG、C-P改善程度及低血糖发生情况相似。
Objective: To comparison the clinical efficacy of insulin degludec (IDeg) and insulin de-gludec/insulin aspart (IDegAsp) combined with insulin aspart in the treatment of type 2 diabe-teswith poor islet function, respectively. Methods: 40 patients with type 2 diabetes with poor islet function were selected from the Affiliated Hospital of Weifang Medical College from June 2020 to October 2021. According to different treatment schemes, they were divided into IDeg group and IDegAsp group, with 20 patients in each group. IDeg group was given insulin aspart once before breakfast, lunch and dinner + IDeg once before going to bed, respectively subcutaneous injection; while IDegAsp group was given IDegAsp once before breakfast and dinner + insulin aspart once be-fore lunch, respectively subcutaneous injection. The changes of blood glucose indexes [fasting blood glucose (FPG), 2 h postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c), serum C-peptide (C-P) and the incidence of hypoglycemia] were compared between the two groups after 6 months of treatment. Results: After treatment, FPG, 2hPG and HbA1c in the two groups were signif-icantly lower than those before treatment (P < 0.001), and C-P was significantly higher than that before treatment (P < 0.001); there was significant difference in 2hPG and HbA1c between the two groups (P < 0.05). There was no significant difference in the incidence of FPG, C-P and hypoglycemia between the two groups (P > 0.05). Conclusion: Both groups had significantly hypoglycemic effect, and the glycosylation level and islet function were improved; however, the levels of lowering 2hPG and HbA1c in IDeg group were better than those in IDegAsp group. The improvement of FPG and C-P and the incidence of hypoglycemia were similar between the two groups.