| Background:In recent years,with the change of diet and living habits,and the aging of our population,the incidence rate of elderly diabetes has been increasing year by year,while type 2 diabetes mellitus is the main type of diabetes in the elderly.At present,diabetes patients are mainly treated by lifestyle intervention and drug hypoglycemic.Research shows that with the age and the duration of diabetes,the effect of oral hypoglycemic drugs alone is not good or even ineffective,and insulin should be used in time.The elderly usually have a long course of disease,low compliance,high rate of overweight or obesity,and their physiological functions are greatly reduced.Therefore,the elderly type 2 diabetes patients are prone to hypoglycemia and weight gain when they are treated with insulin.Therefore,in insulin selection,we should not only effectively control blood sugar,but also avoid hypoglycemia,not gain weight,and have good compliance Necessary.In order to determine the efficacy and safety of two different initial insulin treatment regimens in elderly type 2 diabetic patients with failure of oral hypoglycemic drugs,the following studies were conducted.Objective:Insulin glargine and insulin aspartate 30 were used to treat the elderly type 2 diabetes patients with failure of oral antidiabetic drugs.The clinical efficacy and safety of the two groups were analyzedMethods:A retrospective analysis method was used to select 118 elderly type 2 diabetes patients who were hospitalized in the endocrine Department of Liaocheng Central Hospital from November 2016 to November 2018 with failure of oral antidiabetic drugs and met the established inclusion and exclusion criteria.According to the treatment plan,the patients were divided into insulin glargine group(n=59).The patients were treated with insulin glargine on the basis of the original oral hypoglycemic drug plan,and the other group was treated with insulin aspart 30(n=59).The patients were treated with insulin aspart 30 injection(alone or with 1-2 oral hypoglycemic drugs),and relevant data were collected.The patients in the two groups were followed up 24 weeks later and recorded fasting blood glucose,2 hours postprandial blood glucose,glycosylated hemoglobin and BMI.The rate of glycosylated hemoglobin reaching the standard and the incidence of adverse reactions were observed.The results of the above indicators were statistically analyzed.Results:1)Before treatment,there was no significant difference in the general data(gender,age,weight,height,waist circumference)and course of disease,fasting blood glucose,2-hour postprandial blood glucose,glycosylated hemoglobin and BMI between the two groups(P>0.05).2)After 24 weeks of treatment,compared with before treatment,fasting blood glucose,2-hour postprandial blood glucose and glycosylated hemoglobin in insulin glargine group and insulin aspart 30 group decreased significantly(P<0.01),while body weight,BMI and waist circumference did not change significantly(P>0.05).3)After treatment,there was no significant difference in fasting blood glucose and 2-hour postprandial blood glucose between insulin glargine group and insulin aspart 30 group(P>0.05).In glycosylated hemoglobin,insulin aspart 30 group decreased more significantly than insulin glargine group(P<0.05),and the difference was statistically significant.4)After treatment,the body weight and waist circumference of patients in insulin glargine group were significantly lower than those in insulin aspart 30 group,and the effect on BMI was smaller,the difference was statistically significant(P<0.05).5)There was no significant difference in the incidence of hypoglycemia between insulin glargine group and insulin aspart 30 group(P>0.05),no serious hypoglycemia occurred in both groups.6)After treatment,there was no significant difference in fasting blood glucose standard-reaching rate,2 hours postprandial blood glucose standard-reaching rate and HbAlc standard-reaching rate between insulin glargine group and insulin aspart 30 group(P>0.05).7)After treatment,the baseline data of all patients in the two groups whose HbAlc up to standard(＜=7.0%)and HbAlc not up to standard were compared,It was found that fasting blood glucose,2-hour postprandial blood glucose and glycosylated hemoglobin were the factors influence glycosylated hemoglobin up to standard,the difference was statistically significant(P<0.05).Conclusions:1.For the elderly type 2 diabetic patients with failure of oral hypoglycemic drugs,insulin glargine and insulin aspart 30 can effectively play a clinical therapeutic role,in which insulin aspart 30 can reduce glycosylated hemoglobin more significantly,and insulin glargine has more advantages in reducing the weight and waist circumference of patients.2.There was no significant difference in safety between the two methods.The combination of oral medicine and insulin can not only effectively control blood glucose,but also not increase body weight,waist circumference and BMI in the elderly type 2 diabetic patients with failure of oral hypoglycemic drugs.It can be used as a treatment measure for the elderly type 2 diabetic patients with failure of oral hypoglycemic drugs. |
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