甘精胰岛素和诺和灵N分别与格列美脲联合治疗2型糖尿病疗效比较

目的比较甘精胰岛素和诺和灵N分别与格列美脲联用治疗2型糖尿病患者的疗效。方法选择40例口服降糖药治疗至少3个月而血糖控制不佳（HBA1c〉7．0％）的2型糖尿病患者自选睡前注射一次甘精胰岛素或诺和灵N联用格列美脲2～4mg早晨一次口服治疗16周。比较甘精胰岛素组或诺和灵N组治疗前后FPG和HbA1c的变化并评估两组间的差异性。结果治疗16周时，甘精胰岛素组和诺和灵N组的HbA1c值分别下降1．9±0．8％和1．8±0．9％（P=0．6864），空腹血糖水平分别下降3．5±1．4mmol／L和3．1±1．5mmol／L（P=0．4373），两组疗效间的差异均无统计学意义。甘精胰岛素组较诺和灵N组发生症状性低血糖人数（6／14 vs 14／6；P=0．0105）和发生夜间低血糖次数（6 vs 31；P=0．0040）都显著性减少。结论睡前注射一次甘精胰岛素或诺和灵N联用格列美脲2～4mg早晨口服的治疗方法可使单纯口服降糖药控制不佳的2型糖尿病患者得到良好的血糖控制。两种方法的疗效大致相同，但甘精胰岛素治疗低血糖事件发生率低，故更具选择优势。

Comparison of Therapeutic Effects Between Glargine and Novolin N Combined Respectively with Glimepiride in Type 2 Diabetes Mellitus

Objective To study comparison of therapeutic effects between glargine and Novolin N combined respectively with glimepiride in type 2 diabetes mellitus. Methods Fourty two patients with type 2 diabetes in plasma glucose poorly controlled （ HBA1 c 〉 7.0 % ） with treatment of oral hypoglycemic agents at least three months, free choice by oneself, injected glargine or Novolin N before sleep combined with treatment of glimepiride 2 -4 mg in the morning once every day for 16 weeks. The changes of FPG 和 HbAlc levels before and after the treatment were compared between glargine group and Novolin N group, and differences between the two groups were evaluated. Results By 16 weeks, the mean value of HbAlc in glargine group and Novolin N group decreased respectively 1.9 ±0. 8% and 1.8 ±0. 9% （P =0. 6864） , the mean value of FPG decreased respectively 3.5 ±1.4 mmol/L 和 3.1± 1.5 mmol/（ P = 0. 4373 ） , there were no significant difference at efficacy between the two groups. The numbers of symptomatic hypoglycaemia （6/14vs14/6 ; P =0. 0105 ） and incidence of hypoglycemia at night（6vs31 ;P =0. 0040） decreased significantly in glargine group compared with Novolin N group. Conclusion The present study showed that patients with type 2 diabetes in plasma glucose poorly con- trolled with treatment of oral hypoglycemic agents can be well controlled by injection of glargine or Novolin N before sleep combined with treatment of glimepiride 2 - 4 mg in the morning once every day. The efficacy in two methods of injection with glargine or Novolin N is similar, but treatment of glimepifide is lower in incidence of hypoglycemia thus much selective advantage than Novolin N.