摘要
目的：探讨甘精胰岛素联合格列美脲治疗初诊2型糖尿病（T2DM）的疗效和安全性。方法选择100例口服降糖药疗效不理想的 T2DM患者，采用数字表法随机分为治疗组和对照组各50例。治疗组采用甘精胰岛素联合格列美脲治疗，对照组采用甘精胰岛素治疗。治疗12周后，观察两组空腹血糖（FPG）、2 h 血糖（2hPG）、体质量指数（BMI）、糖化血红蛋白（HbA1c）、胰岛β细胞功能指数（HOMA-β）、胰岛素抵抗指数（HOMA-IR）、胰岛素（INS）用量、血糖达标时间、体质量增加等指标的变化，同时观察低血糖事件的发生情况。结果治疗后，对照组 FPG、2 hPG、HbAlc、HOMA-β、HOMA-IR[（5．7±0．8）mmol／L、（8．6±2．5）mmol／L、（6．5±0．7）％、（40．35±3．12）、（2．68±1．41）]均较治疗前[（11．7±1．6）mmol／L、（15．1±6．1）mmol／L、（9．2±1．1）％、（19．01±2．79）、（3．42±1．47）]明显好转（t ＝23．717、6．971、14．642、36．052、2．568，P ＜0．01或0．05）；治疗组 FPG、2hPG、HbAlc、HOMA-β、HOMA-IR[（5．6±0．7）mmol／L、（7．3±2．3）mmol／L、（6．3±1.0）％、（54．18±3．23）、（2．12±1．26）]均较治疗前[（11．8±1．7）mmol／L、（15．8±5．2）mmol／L、（9．3±1.2）％、（18．71±3．12）、（3．36±1．56）]明显好转（t ＝23．846、10．570、13．580、55．849、4．372，均 P ＜0．01）；治疗组2 hPG、HOMA-β、HOMA-IR、胰岛素剂量、达标时间、体质量增加的幅度[（7．3±2．3）mmol／L、（54．18±3．23）、（2．12±1．26）、（18．06±1．43）U ／d、（10．1±2．4）d、（1．1±0．4）kg]]等指标明显优于对照组[（8．6±2．5）mmol／L、（40．35±3．12）、（2．68±1．41）、（22．46±1．77）U ／d、（13．2±2．6）d、（2．1±0．6）kg]（t ＝23.717、6．971、14．642、36．052、2．568，P ＜0．01或0．05）；治疗组发生低血糖事件4例（8．0％），对照组发生低血糖事件13例（26．0％），两组差异有统计学意义（χ2＝5．535，P ＜0．05）。结论甘精胰岛素联合格列美脲能有效改善 T2DM患者血糖水平，促进胰岛β细胞功能恢复和缓解胰岛素抵抗，尚可减少胰岛素用量、缩短血糖达标时间、减低体质量增加幅度和降低低血糖不良事件发生，是临床上治疗初诊 T2DM患者行之有效的方案之一。
Objective To study the efficacy and safety of glargine insulin combined with glimepiride therapy in type 2 diabetes mellitus（T2DM）.Methods According to the random number table,100 T2DM patients with unsatisfactory efficacy of oral hypoglycemic agents were randomly divided into treament group and control group, 50 cases in each group.Then,the treatment group was dealed with glargine insulin and glimepiride,the control group were treated with insulin glargine for our treatment protocol.12 weeks after treament,the fasting blood glucose（FPG）, 2 hours blood glucose（2hPG）,body mass index（BMI）,glycosylated hemoglobin（HbA1c）,islet β-cell function index（HOMA -β）,insulin resistance index（Homa -IR）,insulin dosage（INS）,time requirds,weight gain and so on were observed.Meanwhile,The occurrence condition of hypoglycemia was also observed.Results In control groups, the post -treatment indexes of FPG,2hPG,HbAlc,HOMA -βand HOMA -IR[（5.7 ±0.8）mmol/L,（8.6 ± 2.5）mmol/L,（6.5 ±0.7）%,（40.35 ±3.12）,（2.68 ±1.41 ）]were much better than those in pre -treatment [（11.7 ±1.6）mmol/L,（15.1 ±6.1 ）mmol/L,（9.2 ±1.1 ）%,（19.01 ±2.79）,（3.42 ±1.47）]（t =23.717, 6.971,14.642,36.052,2.568,P 〈0.01 or 0.05 for both）.In the treatment group,the post -treatment indexes of FPG,2hPG,HbAlc,HOMA -β,HOMA -IR[（5.6 ±0.7）mmol/L,（7.3 ±2.3）mmol/L,（6.3 ±1.0）%,（54.18 ± 3.23）,（2.12 ±1.26 ）]improved obviously than those in pre -treatment [（11.8 ±1.7 ）mmol/L,（15.8 ± 5.2）mmol/L,（9.3 ±1.2）%,（18.71 ±3.12）,（3.36 ±1.56）]（t =23.846,10.570,13.580,55.849,4.372,P 〈0.01 for both）.After treatment,the indexes of 2hPG,HOMA -β,HOMA -IR,insulin dose,time requirds and ampli-tude of weight gain[（7.3 ±2.3）mmol/L,（54.18 ±3.23）,（2.12 ±1.26）,（18.06 ±1.43）U /d,（10.1 ±2.4）d, （1.1 ±0.4kg）]etc in the treatment group were significantly ameliorated than those in the control group[（8.6 ± 2.5）mmol/L,（40.35 ±3.12）,（2.68 ±1.41 ）,（22.46 ±1.77）U /d,（13.2 ±2.6）d,（2.1 ±0.6）kg]（t =23.717,6.971,14.642,36.052,2.568,P 〈0.01 or 0.05 for both）.Hypoglycemia events of treatment group were 4 cases（8.0%）and the same in the control group were 13 cases（26.0%）,there were statistical significance between the two groups（χ2 =5.535,P 〈0.05）.Conclusion Treatment of glargine insulin combined with glimepiride can improve blood glucose level of T2DM patients,recover their islet β-cell function,relieve the IR,shorten the time requirds,as well as reduce the insulin dosage,range of weight gain and rate of hypoglycemia events.Hence,treatment protocol of glargine insulin combined with glimepiride is an effective clinical treatment for newly diagnosed T2DMpatients.
出处
《中国基层医药》
CAS
2015年第10期1546-1549,共4页
Chinese Journal of Primary Medicine and Pharmacy
关键词
糖尿病
2
型
甘精胰岛素
格列美脲
Diabetes Mellitus, Type 2
Glargine Insulin
Glimepiride
