口服降糖药血糖控制不佳患者加用降糖药或胰岛素的疗效及对抑郁情绪的影响
投稿时间:2015-04-09  修订日期:2015-04-20  点此下载全文
引用本文:邓云,彭嵘,李丽华,杨黎娟,贝鹏剑,成玮,冯晓波.口服降糖药血糖控制不佳患者加用降糖药或胰岛素的疗效及对抑郁情绪的影响[J].医学研究杂志,2015,44(11):115-117
DOI: 10.11969/j.issn.1673-548X.2015.11.032
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作者单位
邓云 200137 上海市第七人民医院内分泌科 
彭嵘 200137 上海市第七人民医院内分泌科 
李丽华 200137 上海市第七人民医院内分泌科 
杨黎娟 200137 上海市第七人民医院内分泌科 
贝鹏剑 200137 上海市第七人民医院内分泌科 
成玮 200137 上海市第七人民医院内分泌科 
冯晓波 200137 上海市第七人民医院内分泌科 
中文摘要: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、2hPG及HbA1c水平均明显下降,而胰岛素组的HbA1c水平显著低于降糖药组(t=-4.23,P<0.05),两组治疗后FBG、2hPG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。
中文关键词:2型糖尿病  降糖药  胰岛素  血糖控制  抑郁
 
Efficacy and Influence on Depression of Additional Insulin or Antidiabetic Drug in Poorly Controlled Type 2 Diabetes with One Antidiabetic Drug.
Abstract: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 cases 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 HbA1c in both groups were all reduced, the level of HbA1c 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 significantly 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 antidiabetic drug group, the incidence of hypoglycemia and symptomatic hypoglycemia in insulin group were significantly reduced(P<0.05). Conclusions Combination use of basal insulin or antidiabetic drug for poorly controlled T2DM with one antidiabetic drug can effectively control blood sugar, but insulin detemir can improve the depression symptom, has lower blood glucose fluctuation, and incidence of hypoglycemia.
keywords:Type 2 diabetes  Antidiabetic drug  Insulin  Glycemic control  Depression
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