2型糖尿病患者在富含碳水化合物的餐前注射优泌乐50。

Humalog Mix50 before carbohydrate-rich meals in type 2 diabetes mellitus.

作者信息

Roach P, Arora V, Campaigne B N, Mattoo V, Rangwala S

机构信息

Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.

出版信息

Diabetes Obes Metab. 2003 Sep;5(5):311-6. doi: 10.1046/j.1463-1326.2003.00277.x.

DOI:10.1046/j.1463-1326.2003.00277.x

PMID:12940868

Abstract

AIM

To compare pre-meal injection of Humalog Mix50 (Mix50) and Humalog Mix25 (Humalog Mix75/25 in the US; Mix25) with respect to 2 h postprandial (2 h pp) blood glucose (BG) control after a carbohydrate-rich breakfast in patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS

One hundred and sixteen patients were enrolled in a 16-week crossover trial and received two treatment regimens in a randomized crossover fashion: (i) Mix50 before breakfast and Mix25 before the evening meal (Mix50/Mix25) and (ii) Mix25 before both breakfast and the evening meal (Mix25 twice daily). Insulin doses were adjusted according to stated glycaemic targets. After 6 and 8 weeks of treatment, the patient's usual morning insulin dose was administered, followed immediately by a test breakfast representative of the patient's usual breakfast meal. Fasting and 2 h pp BG concentrations were measured at the time of the test meal. Haemoglobin A1c (A1C) was measured, and information regarding hypoglycaemia (symptoms) was collected at the end of each treatment period.

RESULTS

Insulin doses were similar between treatments (morning = 31-33 U, evening = 26-28 U) at endpoint. Following the test breakfast, the 2 h pp BG was lower (10.9 +/- 0.3 mmol/l vs. 12.4 +/- 0.3 mmol/l, p = 0.0012) and the 2 h pp BG excursion was smaller (1.4 +/- 0.28 mmol/l vs. 3.5 +/- 0.28 mmol/l, p < 0.001) during treatment with Mix50/Mix25 than during treatment with Mix25 twice daily. There was no difference between the treatments with respect to fasting BG (Mix50/Mix25, 9.5 +/- 0.3 mmol/l vs. Mix25 twice daily, 8.9 +/- 0.3 mmol/l; p = NS), A1C (8.14% +/- 1.14% vs. 8.14% +/- 1.07%; p = NS) or the incidence of self-reported hypoglycaemia (34% vs. 23%; p = NS).

CONCLUSIONS

Compared with treatment with Mix25 twice daily, treatment with Mix50 before breakfast and Mix25 before the evening meal resulted in better pp glycaemic control following a carbohydrate-rich meal, and similar fasting BG, A1C and incidence of hypoglycaemia in patients with type 2 diabetes.

摘要

目的

比较2型糖尿病患者早餐前注射优泌乐50（Mix50）和优泌乐25（在美国为优泌乐75/25；Mix25）后，富含碳水化合物早餐后2小时餐后血糖（2h pp BG）的控制情况。

研究设计与方法

116例患者参加了一项为期16周的交叉试验，以随机交叉方式接受两种治疗方案：（i）早餐前注射Mix50，晚餐前注射Mix25（Mix50/Mix25）；（ii）早餐和晚餐前均注射Mix25（每日两次Mix25）。胰岛素剂量根据设定的血糖目标进行调整。治疗6周和8周后，给予患者通常的早晨胰岛素剂量，随后立即给予一份代表患者通常早餐的试验早餐。在试验餐时测量空腹和2h pp BG浓度。测量糖化血红蛋白（A1C），并在每个治疗期结束时收集有关低血糖（症状）的信息。

结果

在终点时，两种治疗之间的胰岛素剂量相似（早晨=31 - 33 U，晚上=26 - 28 U）。试验早餐后，Mix50/Mix25治疗期间的2h pp BG较低（10.9±0.3 mmol/L对12.4±0.3 mmol/L，p = 0.0012），2h pp BG波动较小（1.4±0.28 mmol/L对3.5±0.28 mmol/L，p < 0.001），优于每日两次Mix25治疗期间。两种治疗在空腹BG方面无差异（Mix50/Mix25，9.5±0.3 mmol/L对每日两次Mix25，8.9±0.3 mmol/L；p =无统计学意义），A1C（8.14%±1.14%对8.14%±1.07%；p =无统计学意义）或自我报告的低血糖发生率（34%对23%；p =无统计学意义）。