摘要
目的探讨甘精胰岛素联合瑞格列奈治疗2型糖尿病的疗效。方法将110例2型糖尿病患者随机分为观察组55例和对照组55例。两组患者均给予糖尿病教育、控制饮食、运动疗法等基础治疗，观察组睡前皮下注射甘精胰岛素，初始剂量为0．2U·kg-1·d-1，餐前口服瑞格列奈，3—6mg／d，分3次服用；对照组给予精蛋白生物合成人胰岛素注射液（预混30R），起始剂量0．4U·kg-1·d-1，疗程均为3个月。观察两组治疗前后空腹血糖（FPG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbAlc）、胰岛素抵抗指数（Homa—IR）、胰岛素分泌指数（Homa-8）、血糖达标时间、低血糖事件。结果两组治疗后FPG、2hPG、HbAlc、Homa—IR均较治疗前明显降低（均P〈0．01），Homa-8均明显升高（均P〈0．01）；治疗后观察组HbAle、Homa-IR均较对照组明显下降（t=2．786、3．449，均P〈0．01），Homa—β较对照组明显升高（t=-4．833，P〈0．01）；观察组血糖达标时间明显短于对照组（t=2．126，P〈0．01）；观察组未出现低血糖，对照组出现4例低血糖，观察组低血糖发生率低于对照组（x2=4．151，P〈0．05）。结论甘精胰岛素联合瑞格列奈能平稳降低血糖至正常水平，并保持血糖稳定，促进胰岛B细胞功能恢复，减轻胰岛素抵抗，减少胰岛素用量，降低不良反应发生，值得临床推广使用。
Objective To investigate the effect of repaglinide combined with insulin glargine in the treatment of patients with type 2 diabetes. Methods 110 patients with type 2 diabetes were randomly divided into the control group and observation group,each group 55 cases. The control group was given novolin 30R, initial dose of 0.4U ·kg-1·d-1. The observation group was given subcutaneous injection of insulin glargine at bedtime, the initial dose of 0.2U·kg-1·d-1 ,preprandial oral repaglinide,3 of 6mg/d,divided into three doses,two groups were observed for 3 months, the difference of fasting plasma glucose （FPG）, 2h postprandial glucose （2hPG）, glycated hemoglobin （ HbA1 c）, Homa-IR, Homa-13, hypoglycemia, blood glucose time were compared before and after treatment. Results After treatment, FPG,2hPG, HbAlc, Homa-IR were significantly lower than before treatment, and Homa-β was signifi- cantly higher than that before treatment（ all P 〈 0.01 ） ;After treatment, HbA1 c, Homa-IR were lower than the control group significantly （ t = 2.786,3. 449, all P 〈 0.01 ）, and Homa-β was significantly higher than the control group （ t = -4. 833 ,P 〈 0.01 ）;The blood glucose compliance time of the Observation group was significantly shorter than the control group （ t = 2. 126, P 〈 0.01 ） ; The observation group had 0 case of low blood sugar, and the control group had 4 cases of low blood sugar, the difference was statistically significant（ x2 = 4.151, P 〈 0.05 ）. Conclusion Repaglinide combined with insulin glargine in the treatment of patients with type 2 diabetes could quickly reduce blood sugar,reduce blood glucose to normal levels, keep blood sugar stable, restore β-cell function, reduce insulin resistance, reduce insulin dosage, reduce adverse events, and it was worthy of clinical use.
出处
《中国基层医药》
CAS
2012年第10期1470-1471,共2页
Chinese Journal of Primary Medicine and Pharmacy
