Clinical Observation Of Acarbose In Intensive Insulin Therapy Of Type 2 Diabetes

Objective:Observation Acarbose Assisted intensive insulin therapy and simple intensive insulin therapy type 2 diabetes(T2DM)about clinical effect, to assess the function of Acarbose in intensive insulin therapy.Meathods:62 cases of T2DM patients accept intensive insulin therapy combined acarbose (Joint strength group) and simple intensive insulin therapy (simple intensive group) respectively, when glucose controlling reaching standards use Continuous glucose monitoring system (CGMS) to measure two groups'glucose changing for 72 hours, according to CGMS's evaluation parameter and the average time of patients'reaching standards at that time,and dosage of insulin to compare at two groups' short term effect; After 3 months of treatment, comparing two groups long term effect according to controlling low-glucose incidence during treatm-ent,HbA1C level after treatment and HbA1C percentage, and body mass index(BMI). CGMS'evaluation parameter included Mean level of 24 h blood glucose value (24hMBG), Mean blood glucose levels 1 h before breakfast(before meal 1h MBG),Mean blood glucose levels 3 h after breakfast(after meal 3hMBG),High glucose area under curve(HAUC), Low glucose under curve(LAUC), The mean of daily differences(MODD), Mean amplitude of glycaemic excursion(MAGE), Standard deviation of blood glucose(SDBG),Range of glycaemic fluctuation (LAGE),low glucose inci-dence(PT1),high glucose incidence(PT2),The percentage of time-3(PT3).Results:1. Comparing of short term effect:(1) Joint strength group is better than simple intensive group at glucose controlling:24h MBG: [(7.08±0.69)mmol/l vs (8.27±1.31)mmol/l,P<0.001)]; before meal 1h MBG: [breakfast:(6.72±0.85)mmol/lvs (8.05±1.74)mmol/l, P<0.001; lunch: (6.63±1.26)mmol/lvs(8.24±1.71)mmol/l,P<0.001;dinner:(7.64±1.26)mmol/ 1vs(8.99±2.44)mmol/l,P<0.01];after meals 3hMBG:[(break-fast:(7.97±1.29) mmol/lvs(9.67±1.93)mmol/l,P<0.001;lunch:(7.62±1.47)mmol/lvs(9.02±2.2 3)mmol/l,P<0.001;dinner:(7.35±1.19)mmol/l vs(9.22±1.88)mmol/l,P<0.00 1)].(2) Joint strength group is lower at glucose fluctuation than simple intensive group:MODD:[(0.57±0.49)mmol/lvs(1.10±0.69)mmol/l, P<0.01], MAGE:[(3.76±1.47)mmol/lvs(6.52±1.57)mmol/l,P<0.001],SDBG:[(1.44±0.60)mmol/lvs(2.42±0.92)mmol/l, P<0.001].(3)The average insulin dosage of glucose reaching standards of Joint strength group is less than simple intensive group:(0.55±0.13)u·kg-1·-1 vs (0.76±0.18)u·kg-1·-1,p<0.001. (4)The average time of glucose reaching standards of Joint strength group is shorter than simple intensive group:(6.97±1.85)d vs(8.29±1.58)d, P<0.01.2.Comparing of long term effect:(1)Two groups'HbA1c level decline obviously:Joint strength group HbAlc level [from (9.66±2.21)% down to (6.86±0.60)%, p<0.001],simple intensive group HbAlc level [from (9.42±1.66)% down to (7.16±0.69)%,p<0.001];but the difference of HbAlc level after treatment has no statistics meaning:[(6.86±0.60)% vs(7.16±0.69)%,p>0.05].The percentage of Joint strength group HbAlc is higher than simple intensive group:According to HbA1c<7.0% 47.8%vs 23.8%,p<0.01;According to HbA1c<6.5% standards:78.3%vs 61.9%, p<0.01.(2) Joint strength group is lower than simple intensive group at low-glucose incidence:35%vs62%,P<0.01.(3)after treatment average insulin dosage of Joint strength group is lower than simple intensive group[(0.45±0.10)u·kg-1·-1 vs(0.55±0.12)u·kg-1·-1, P<0.05].(4) Joint strength group'BMI is lower than simple intensive group:[(24.39±2.58) kg/ m2 vs(27.86±3.41) kg/m2, p<0.001].Conclusion:Acarbose combined intensive insulin therapy, patients is better at glucose controlling, lower at glucose fluctuation, lower at lowglu-cose incidence,a better glucose steady.average Insulin with less, and keep weight not increase.