胰岛素泵联合口服降糖药治疗2型糖尿病的疗效比较

[目的]比较胰岛素泵分别联合吡格列酮、二甲双胍、阿卡波糖、格列美脲治疗2 型糖尿病的疗效.[方法]80例血糖控制欠佳的2型糖尿病患者停用原来治疗方案,改用胰岛素泵治疗,1周后随机分为A组、B组、C组、D组4组.A组胰岛素泵联合格列美脲,B组胰岛素泵联合吡格列酮, C组胰岛素泵联合二甲双胍, D组胰岛素泵联合阿卡波糖,共治疗4周.对比分析4组空腹血糖（FPG）、早餐后2 h血糖 （2hPG）、糖化血红蛋白（HbA1c）、胰岛素用量、血糖达标时间及低血糖发生情况.[结果]治疗后4组 FBG、2hPG 、HbA1c均较治疗前明显下降（ P 〈0.01）;四组之间胰岛素用量、血糖达标时间比较差异无显著性（ P 〈0.01）; B 、C、D组低血糖发生率差异无显著性,但均与A组比较差异有显著性（ P 〈0.01）.[结论]胰岛素泵分别联合格列美脲、吡格列酮、二甲双胍、阿卡波糖治疗能较好地控制2 型糖尿病患者血糖,但分别联合二甲双胍、阿卡波糖、吡格列酮时安全性更高.

Effects of Insulin Pump Combined with Oral Hypoglycemic Agents for the Treatment of Type 2 Diabetic Patients

[Objective] To compare the effects of insulin pump combined with pioglitazone, metformin, acarbose or glimepiride for the treatment of Type 2 diabetic patients. [Methods] A total of 80 Type 2 diabetic patients with poor glycemie control stopped original regimen and switched to insulin pump therapy. After 4 weeks, they were randomized into group A, group B, group C and group D. Group A received insulin pump combined with glimepiride, and group B received insulin pump combined with pioglitazone, and group C received insulin pump combined with metformin, and group D received insulin pump combined with acarbose. The duration of therapy was 4 weeks. Fasting blood glucose（FBG）, postprandial 2h-glucose（2hPG）, glycosylated hemoglobin（HbAlc）, insulin dose, duration to reach glycemie control and the incidence of hypoglycemia were analyzed comparatively among 4 groups. [Results] Compared with before treatment, FBG, 2hPG and HbAlc in 4 groups after treatment decreased significantly（ P 〈0.01）. There was no significant difference in insulin dose and the duration to reach glycemic control among 4 groups（ P 〈0.01）. There was no statistical difference in the incidence of hypoglycemic rate among group B, group C and group D, but there was significant difference between group B, C, D and group A（ P〈0.01）. [Conclusion]Insulin pump combined with glimepiride, pioglitazone, metformin or acarbose can better control the blood glucose of Type 2 diabetic patients, but insulin pump combined with metform, acarbose or pioglitazone have higher safety.