遗憾的是，我不知道国外有哪些好一些的网站，随便找了一篇，越译越觉得没什么帮助。。。权当试卷吧。如果可以，请告我些网站，我可以找时间译译。对医学词汇和糖尿病的了解实在有限，如果不行，也没关系，以免翻错了，给大家误导就麻烦了。
--------------------------------------------------------
研究证明一天一次胰岛素注射同样有效
研究报告称，2型糖尿病一天注射一次胰岛素与一天注射三次胰岛素在控制血糖水平方面效果相同。
一天一剂的甘精胰岛素（Lantus）与进餐时服用的赖脯胰岛素(Humalog) ，都已经上市了。最新国际研究发现病人对甘精的满意度相对更高些。此研究确认了胰岛素的有效性，以及在口服药不起作用的情况下，有必要使用胰岛素。这当然不是一件事好与不好的问题。
新的研究还显示在病人满意度及低血糖方面，甘精有些许的优势。但此研究是由甘精制造商资助的。然而，其它胰岛素制造商赞助的研究也显示出其产品的这类些微优势。
这些结果发布在3月29日出版的The Lancet杂志上。
保持严格的血糖控制对于避免包括失明、肾衰、甚至截肢在内的糖尿病并发症至关重要。
美国糖尿病协会推荐糖化血红蛋白A1c的浓度—一种血糖控制的指标—保持在7%以下。较低的水平能够充分减少糖尿病并发症的风险。
2型糖尿病—经常与超重有关—是因身体无法适度使用用来向细胞输送血糖的激素胰岛素而造成的。1型糖尿病，不太常见，是由身体无法制造胰岛素而引起的。
口服药，与控制饮食及运动一起，在2型糖尿病初期通常能起到控制作用。但是，在许多情况下，随着疾病的发展，病人需要摄取胰岛素。
糖尿病是世界性的流行病，研究血糖控制是非常重要的。许多糖尿病病人没有很好地控制其血糖，而且2型糖尿病人在治疗中胰岛素使用得不够早，以至没能最大限度地得到益处。
甘精作为一种“基础“胰岛素类似物，意味着一天一次，或者在早上或者在晚上；它能持续24小时。赖脯是短效药，进餐时服用。
在新的研究中，对400名经口服药控制效果不良的2型糖尿病男女病人随机接受甘精或优泌乐。 测试是在欧洲和澳洲的69个研究地点进行，历时44周。所有参加人员连续服用口服药。
两组的血糖控制水平相当，甘精组降幅1.7个百分点，优泌乐1.9个百分点。
甘精组的低血糖风险较低。它的优势还在于注射的次数较少以及一天中需要进行血糖监控的时间较少（仅在早餐前一次）。研究人员还说，使用甘精的人较少有体重的增加。
当然，甘精似乎还为2型糖尿病提供了另一种可行的选择，它符合目前的治疗方案。 “美国糖尿病协会”对2型糖尿病人有一种共识的疗法，胰岛素建议作为第二或第三线治疗。这一建议是用基础胰岛素作为开始，但这只是初步治疗，因为，说服病人一天注射一次比较容易些。
Dr. Juan Castro，得克萨斯A&M健康科学中心海湾健康教育中心负责人说，“我不认[新的研究]会对我们现在所做的一切产生革命性的改变，但对于临床医生来说，[新的研究]对我们所知道的拉美人群确实有帮助。历史上曾有很多拉美病人抵抗胰岛素治疗这一方法。这一基础胰岛素对帮助病人接受胰岛素是一种很好的过渡，因为它只需每天一次。如果2到3个月后，我们需要让他们使用赖脯胰岛素，他们就会比较容易接受了。
Once-Daily Insulin Shot Proves Effective in Study
By Amanda Gardner
HealthDay Reporter
THURSDAY, March 27 (HealthDay News) — Researchers report that a once-daily shot of insulin appears to control blood sugar levels in people with type 2 diabetes just as well as injecting insulin three times a day.
The once-a-day formulation, known as insulin glargine (Lantus), is already on the market, as is insulin lispro (Humalog), which is taken with meals. The new, international study found more patient satisfaction with the glargine.
"This study just confirms that insulin is effective and there are good reasons to use insulin if oral agents are not working," said Dr. Sue Kirkman, vice president of clinical affairs at the American Diabetes Association. "It's certainly not that one is good and one is bad."
The new study did show slight benefits for insulin glargine in terms of patient satisfaction and low blood sugar. But the study was funded by Lantus' maker, Sanofi Aventis, and other studies funded by makers of other insulin formulations have found slight benefits for those products, too, Kirkman noted.
The results are published in the March 29 edition of The Lancet.
Maintaining strict blood sugar control is critical to avoid the complications of diabetes, which can include blindness, kidney failure, and even amputations.
The American Diabetes Association recommends that concentrations of hemoglobin A1c — a measure of blood sugar control — remain below 7 percent. Lower levels can substantially reduce the risk of diabetes complications.
Type 2 diabetes — often linked to being overweight — is caused by the body's inability to properly use the hormone insulin, which transports blood sugar to the cells for energy. Type 1 diabetes, which is less common, results from the body's failure to produce insulin.
Oral medications, along with lifestyle changes such as improved diet and exercise, can often control type 2 diabetes in the beginning. But, in many cases, insulin needs to be added to a patient's regimen as the disease progresses.
"Diabetes is a worsening epidemic worldwide and studies examining glycemic control are very important," said Dr. Spyros Mezitis, an endocrinologist at Lenox Hill Hospital in New York City. "Diabetes is not well controlled in many patients and insulin is not used early enough in the treatment algorithm for type 2 diabetes to achieve maximal benefit."
Lantus is known as a "basal" insulin analogue, meaning it is given once a day either in the morning or at night; it lasts for about 24 hours. Insulin lispro is shorter-acting and is administered with meals.
For the new study, more than 400 men and women with type 2 diabetes that was poorly controlled by oral medication were randomly assigned to receive either Lantus or Humalog. The trial, conducted at 69 study sites in Europe and Australia, lasted 44 weeks. All participants continued to take oral medications.
Blood sugar control was about equivalent in the two groups, with a decrease of 1.7 percent in the Lantus group and 1.9 percent in the Humalog group.
Lantus was associated with a lower risk of low blood sugar. It also offered the advantages of fewer injections and less blood glucose monitoring throughout the day (only once before breakfast). People taking Lantus also experienced less weight gain, the study authors said.
Certainly, Lantus seems to present another, viable option for people with type 2 diabetes, and one that fits with current treatment recommendations, Kirkman said.
"The American Diabetes Association has a consensus treatment algorithm for type 2 diabetes and insulin is suggested as a second- or third-line treatment," she said. "The suggestion is to start with basal insulin, but that's really primarily because it tends to be easier to convince a patient to go on one shot a day."
Dr. Juan Castro, director of the Texas A&M Health Science Center Coastal Bend Health Education Center, said, "I don't think it [the new study] is going to revolutionize what we're doing but, to clinicians, it really supports what we have seen in the Hispanic population. Historically there has been a lot of resistance with Hispanic patients to accept the idea of being on insulin. This basal insulin gives us a good transition to help patients accept insulin because it's only once a day. If, two to three months later, we need to give them lispro, it's easier for them to accept it."
SOURCES: Sue Kirkman, M.D., vice president, clinical affairs, American Diabetes Association, Alexandria, Va.; Spyros Mezitis, M.D., endocrinologist, Lenox Hill Hospital, New York City; Juan Castro, M.D., director, Texas A&M Health Science Center Coastal Bend Health Education Center, Corpus Christi; March 29, 2008, The Lancet
来源：
http://www.mayoclinic.com/health/diabetes-management/DA00008
