甘精胰岛素联合瑞格列奈治疗老年2型糖尿病并早期糖尿病肾病的临床观察

目的评估甘精胰岛素联合瑞格列奈在老年2型糖尿病并早期糖尿病肾病（Ⅲ期）患者中的降糖作用和安全性。方法选择血糖控制欠佳[糖化血红蛋白（HbA1c）〉7.5%,空腹血糖（FPG）8～13 mmol/L],年龄〉60岁的2型糖尿病合并早期糖尿病肾病（Ⅲ期）患者60例,随机分为两组,治疗组（甘精胰岛素加瑞格列奈组,30例）和对照组（诺和灵30R组,30例）,疗程12周,以两组FPG〈6.7 mmol/L,HbA1c〈7.0%为治疗目标,以两组FPG、餐后2 h血糖（2 h PG）和HbA1c来评价其降糖作用。根据低血糖发生率及血生化指标的变化、评价其安全性,比较两种方法在降糖方面、安全性的差异。结果两组患者的FPG、2 h PG、HbAlc、24 h尿微量白蛋白（24 h尿mAlb）较治疗前显著降低,两组治疗前后差异均有统计学意义（P〈0.05）,但两组间比较差异无统计学意义（P〉0.05）;治疗组低血糖发生率较对照组低,差异有统计学意义（P〈0.05）。结论甘精胰岛素联合瑞格列奈治疗老年2型糖尿病并早期糖尿病肾病患者能有效控制血糖,低血糖发生率低,安全性、依从性更好。

Insulin glargine and repaglinide in the treatment of type 2 diabetic patients in old age and with diabetic nephropathy(DN)at early stage

Objective To evaluate the effect and safety of insulin glargine combined with repaglinide in type 2 diabetic patients in old age and with diabetic nephropathy(DN) at early stage.Methods 60 cases were randomly divided into treatment group and control group,treatment group(insulin glargine and repaglinide,30),and control group(Novolin30 R,30),the period of treatment was 12 weeks.The clinical parameters,such as FPG,2hPG,HbA1c,24h urine-mAlb and hypoglycaemin reaction after treatment were observed.Results After the treatment,there were significant differences of FPG,2hPG,HbA1c,24h urine-mAlb in each group(P<0.05),but no significant difference between two groups.The hypoglycaemin reaction in treatment group is more lower than that in the control group,and there was a statistical significance(P<0.05).Conclusion Insulin glargine and repaglinide can effectively control diabetes glucose in the old patients with diabetic nephropathy(DN) at early stage,with lower hypoglycaemin reaction rate better safety and treatment compliance.