甘精胰岛素联合口服药物治疗2型糖尿病的疗效及安全性分析

目的评价甘精胰岛素联合口服降糖药物（oral hypoglycemic drugs,OADs）治疗方案对使用预混胰岛素血糖控制欠佳的2型糖尿病患者的疗效及安全性。方法预混胰岛素30/70单独或联合使用OADs血糖控制不良的2型糖尿病患者50例,随机分为治疗组（停用预混胰岛素,改为皮下注射甘精胰岛素联合OADs）（n=30）和对照组（继续使用预混胰岛素早晚餐前皮下注射联合OADs）（n=20）,各组均依据血糖监测水平调整胰岛素及OADs用量。12周后对比两组患者空腹血糖（fasting blood glucose,FBG）、三餐后2 h血糖（2-hour postprandial blood glucose,2hPG）、糖化血红蛋白A1c（glycated hemoglobin A1c,HbA1c）、体重指数（body mass index,BMI）及试验期间低血糖发生次数。结果与治疗前相比,治疗组及对照组治疗后HbA1c、FBG、三餐2hPG均有所下降（P均〈0.01）;治疗组BMI无明显变化（P〉0.05）,对照组BMI较治疗前增加（P〈0.01）。与对照组相比,治疗组治疗后FBG、午餐2hPG及HbA1c均低于对照组（P均〈0.01）;治疗组治疗后BMI低于对照组（P〈0.01）;试验期间治疗组低血糖发生次数低于对照组（P〈0.01）。结论预混胰岛素血糖控制欠佳的2型糖尿病患者,改为甘精胰岛素联合OADs治疗,可使FBG和HbA1c显著改善,不增加体重,简便易行,且降低了低血糖风险。

Analysis of Efficacy and Safety of the Treatment of Insulin Glargine Combined with Oral Hypoglycemic Drugs for Type 2 Diabetic Patients

Objective Evaluation of the efficacy and safety of the treatment insulin glargine combined with OADs for type 2 diabetic patients with poor glycemic control using premixed insulin therapy.Methods 50 cases of type 2 diabetic patients were randomly divided into treatment group(convert premixed insulin into insulin glargine plus OADs)(n=30) and control group(continue to use the premixed insulin plus OADs)(n=20),all groups were adjusted the dosage of insulin and OADs based on the levels of blood glucose.After 12 weeks the index of FBG、2hPG、HbA1c、BMI and the incidence of hypoglycemia during the test were compared in two groups.Results Compared with those before treatment,HbA1c、FBG、2hPG of the two groups have declined(P all <0.01);the treatment group has no significant change in BMI(P>0.05).Compared with the control group,FBG、lunch 2hPG and HbA1c of the treatment group is lower(P all<0.01);BMI of treatment group is lower(P<0.01);the incidence of hypoglycemia during the test of the treatment group is lower(P<0.01).Conclusion The treatment of insulin glargine combined OADs for poor glycemic control in type 2 diabetic patients using premixed insulin,can significantly improve the levels of FBG and HbA1c,do not increase body weight,be simple,and can greatly reduce the risk of hypoglycemia.