Curative effect and safety of insulin detemir in treatment of senile type 2 diabetes mellitus

ZHU Wei-hong; YUAN Yue-xing

doi:10.3969/j.issn.1674-4055.2016.07.20

Abstract：Objective To discuss the curative effect and safety of insulin detemir in treatment of senile type 2 diabetes mellitus (T2DM).Methods T2DM patients (n=90, male 54, female 36, aged from 65 to 74 and average age=69.01±3.47) were chosen from Dec. 2013 to Dec. 2015, and divided, according to different types of drugs, into group A, group B and group C (eachn=30). All patients were given health education on diabetes, and promoted to control diet and have some sport exercises. All patients were given hypodermic injection of insulin lispro (4 U) before 3 meals, and in addition, group A was given insulin detemir (8 U), group B, insulin glargine (8 U) and group C, intermediate-acting insulin (Novolin, 8 U) for 3 m. The duration of blood sugar controlled to target levels, dosage of insulin and incidence of hypoglycemia were recorded during treatment period. After treatment for 3 m, the patients were given dynamic blood sugar monitoring for recording 24h mean blood glucose (24h MBG), 24h standard deviation of blood glucose (24h SDBG), mean amplitude of glycemic excursions (MAGE), mean of daily differences (MODD) and postprandial blood glucose excursion (PPGE). The changes of fasting blood glucose (FBG), 2h postprandial blood glucose (2h PBG), glycated hemoglobin (HbAlc) and body mass index (BMI) were detected. The patients were followed up through telephones or clinic for 6 m for recording the incidence of cardiovascular events.Results After treatment for 3 m, BMI, FBG, 2h PBG and HbAlc were significantly lower in group A and group B than those in group C (allP<0.05). The difference in BMI, FBG, 2h PBG and HbAlc had no statistical significance between group A and group B (allP>0.05). During treatment period, the difference in duration of blood sugar controlled to target levels, dosage of insulin and incidence of hypoglycemia had no statistical significance between group A and group B (allP>0.05). The dosage of insulin and incidence of hypoglycemia were significantly lower, and duration of blood sugar controlled to target levels was longer in group A and group B than those in group C (allP<0.05). MBG, SDBG, MAGE, MODD and PPGE all decreased in group A and group B compared with group C (allP<0.05). The incidence of cardiovascular events were significantly in group A and group B than that in group C (16.67%vs. 53.33%; 23.33%vs. 53.33%, allP<0.05).Conclusion The controlling effect on blood sugar and safety of insulin detemir are higher than those of intermediate-acting insulin in elderly patients with T2DM.