瑞格列奈联合甘精胰岛素治疗2型糖尿病的疗效及对胰岛β细胞功能的影响

目的探讨瑞格列奈联合甘精胰岛素治疗2型糖尿病(T2DM)的临床疗效和对胰岛β细胞功能的影响并观察不良反应。方法选取47例T2DM患者,随机分为对照组和观察组。对照组给予甘精胰岛素治疗,观察组在对照组基础上加以瑞格列奈联合治疗,两组患者均连续治疗12 w。分别比较两组患者治疗前后空腹及餐后2 h血糖(FPG和2 h PG)水平、糖化血红蛋白(HbA1c)水平、空腹及餐后C肽水平、胰岛素(FINS)分泌水平以及胰岛β细胞功能,并观察记录治疗过程中的不良反应。结果与治疗前比较,对照组和观察组经过治疗后FPG和2 h PG水平和Hb A1c水平均有显著下降(P0.05);C肽水平、INS分泌水平均有显著升高(P0.05);胰岛β细胞功能有明显改善(P0.05)。与对照组比较,以上指标水平在观察组变化更为显著(P0.05)。结论瑞格列奈联合甘精胰岛素治疗T2DM能够平稳控制血糖水平、改善胰岛β细胞功能,值得临床推广使用。     

西格列汀与瑞格列奈分别联合甘精胰岛素治疗老年2型糖尿病的效果观察

目的探讨西格列汀和瑞格列奈分别联合甘精胰岛素治疗老年2型糖尿病的安全性和疗效。方法将60例口服降糖药血糖控制不佳的老年2型糖尿病患者随机分为两组,即西格列汀联合甘精胰岛素(观察组)和瑞格列奈联合甘精胰岛素组(对照组),治疗3月。观察两组空腹血糖(FBG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、体重指数、胰岛功能及低血糖的发生率。结果与治疗前相比,治疗后两组糖化血红蛋白、空腹血糖、餐后2 h血糖均明显下降(P0.05),但两组间无明显差异,观察组胰岛素使用剂量和低血糖的发生率低于对照组,胰岛功能优于对照组。结论西格列汀联合甘精胰岛素可有效降低血糖,改善胰岛功能,同时胰岛素使用剂量和低血糖发生率更低。     

双相门冬胰岛素30注射治疗初诊2型糖尿病临床观察

将136例T2DM患者分随机为门冬胰岛素30治疗组和甘精胰岛素对照组,均晚餐前注射一次联合三餐后服二甲双胍0.5g或拜糖平50mgtid26周。比较两组患者血糖控制情况及胰岛β细胞功能恢复情况。结果:在降糖,改善胰岛β细胞功能以及低血糖发生等方面比较无显著性差异,但甘精胰岛素组HbA1c值降低幅度要低于门冬胰岛素30组(P0.05)。结论:门冬胰岛素30和甘精胰岛素都具有明显的降低空腹和餐后血糖以及HbA1c的作用,用门冬胰岛素30方法联合口服药治疗初诊2型糖尿病患者可以达到甘精胰岛素方法同样的效果。     

瑞格列奈与甘精胰岛素联合治疗2型糖尿病患者的临床随机对照研究

目的探讨瑞格列奈与甘精胰岛素联合治疗2型糖尿病患者的临床效果。方法选取该院2014年7月—2015年7月收治82例2型糖尿病的患者。按随机数字表法分为对照组和观察组各41例。对照组对患者进行甘精胰岛素临床治疗,观察组使用瑞格列奈联合甘精胰岛素对患者进行临床治疗。最后对2组疗效、治疗后的空腹血糖(FPG)、餐后2 h血糖(2 hPG)以及糖化血红蛋白(HbA1C)进行对比。结果 2组患者经治疗后,观察组患者的总改善率:95.12%,对照组患者的总改善率:78.04%,2组数据对比差异有统计学意义(P0.05)。2组患者在治疗后,空腹血糖(FPG)、餐后2 h血糖(2 hPG)以及糖化血红蛋白(HbA1C)差异有统计学意义(P0.05)。结论在临床上,治疗2型糖尿病时,使用瑞格列奈联合甘精胰岛素能够有效地控制患者的病情,对患者的空腹血糖(FPG)、餐后2 h血糖(2 hPG)以及糖化血红蛋白(HbA1C)均有所改善,并且其治疗方式简易,疗效突出,值得推广。     

瑞格列奈联合甘精胰岛素治疗2型糖尿病的疗效及对胰岛β细胞功能的影响

目的探究瑞格列奈联合甘精胰岛素治疗2型糖尿病(T2DM)的疗效及对胰岛β细胞功能的影响。方法选取2015年7月—2016年7月该院收治的80例T2MD患者为研究对象,使用随机数表法分为两组,各40例。对照组患者在常规治疗基础上使用甘精胰岛素,观察组在对照组基础上联合使用瑞格列奈。对比两组患者治疗12周后HbA1c、2hPG、FPG、HOMA-IR、HOMA-β水平。结果两组患者治疗前HbA1c、2hPG、FPG水平对比,差异无统计学意义(P0.05);治疗后HbA1c、2hPG、FPG水平均较治疗前有所改善,观察组改善幅度优于对照组,差异有统计学意义(P0.05);观察组和对照组治疗后HOMA-IR、HOMA-β水平均较本组治疗前明显改善,差异有统计学意义(P0.05);观察组上述指标改善幅度明显优于对照组,差异有统计学意义(P0.05);两组不良反应发生率对比,差异无统计学意义(P0.05)。结论 2型糖尿病患者接受瑞格列奈联合甘精胰岛素治疗,可有效控制血糖,改善胰岛β细胞功能,安全性好,值得临床推广。     

甘精胰岛素联合瑞格列奈片治疗2型糖尿病疗效观察

60例2型糖尿病患者随机分为甘精胰岛素联合瑞格列奈片治疗组和诺和锐30对照组,疗程12周,12周结束后比较两组FPG、2hPG、空腹C肽、餐后2小时C肽、HbA1c较治疗前均显著改善（P〈0.05）,低血糖发生率治疗组低于对照组（P〈0.05）。结论：甘精胰岛素联合瑞格列奈片可有效降低2型糖尿病患者血糖,低血糖发生率少。     

瑞格列奈联合重组甘精胰岛素治疗和诊断2型糖尿病的疗效观察

将30例初诊断T2DM分为瑞格奈组和瑞格列奈联合重组甘精胰岛素组，治疗12周，观察FBG、2hPG、HbA1c变化比及血糖达标时间。结果联合重组甘精胰岛素组FBG、2hPG、HbA1c均优于瑞格列奈组，且血糖达标时间贪偏短。结论对T2DM病患者，瑞格列奈联合重组甘精岛素治疗效好地抑制血糖，改善胰岛素B细胞功能、C肽分泌改善。     

初发2型糖尿病患者早期胰岛素治疗对β细胞功能影响

选择70例26～58岁初发首次治疗2型糖尿病病人,随机分配到胰岛素治疗组和口服药物治疗组,半年后分析比较两组治疗前后空腹血糖(FPG)及餐后2小时血糖(2HPG)、糖化血红蛋白(HbA1c)、空腹胰岛素和餐后2小时胰岛素、HOMA-β(胰岛素分泌指数)和HOMA-IR(胰岛素抵抗指数).结果胰岛素组胰岛功能有较大的改善,有显著的统计学意义.结论2型糖尿病者早期使用胰岛素有助于β细胞分泌功能的改善.     

格列美脲联合甘精胰岛素注射液对初诊2型糖尿病患者胰岛β细胞功能及血糖控制的影响

选取我院2016年4月-2017年8月治疗的T2DM患者76例,依照不同方案分组平分为照组给予格列美脲治疗,观察组给予列美脲联合甘精胰岛素注射液治疗。观察比较两组胰岛β细胞功能[空腹胰岛素(Fins)、餐后2h胰岛素(2Pins)、空腹C肽(FCP)、餐后C肽(PCP)、胰岛素分泌指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)]改善情况与血糖控制情况[空腹血糖(FBG)、餐后2h血糖(2hPBG)、糖化血红蛋白(Hb A1c)]。结果治疗后观察组Fins、2Pins、FCP、PCP、HOM A-β均高于对照组(P 0. 05),两组HOM A-IR无明显差异(P 0. 05);治疗后观察组FBG、2hPBG、Hb A1c水平均低于对照组(P 0. 05)。结论格列美脲联合甘精胰岛素注射液治疗初诊2型糖尿病患者能显著改善患者胰岛β细胞功能,提高血糖控制能力。     

米格列奈联合甘精胰岛素治疗新诊断2型糖尿病疗效观察

选择新诊断糖化血红蛋白（HbA1c）≥9.0%的2型糖尿病40例,予米格列奈联合甘精胰岛素治疗12周,比较治疗前后空腹血糖（FBG）、餐后2小时血糖（2hPG）、HbA1c及空腹C肽（FC-P）、餐后2小时C肽（2hC-P）,同时观察肝肾功能的变化。结果：治疗后所有患者血糖及HbA1c均明显下降（P〈0.01）,空腹及餐后2小时C肽均较治疗前增加（P〈0.01）,期间发生低血糖事件2例次,肝肾功能无明显变化。结论：米格列奈联合甘精胰岛素治疗能有效、安全控制新诊断2型糖尿病患者血糖,且胰岛功能得到部分恢复。     

瑞格列奈与甘精胰岛素联合治疗新诊断2型糖尿病的疗效观察

目的：比较新诊断2型糖尿病患者应用胰岛素促泌剂瑞格列奈单一治疗及联合长效胰岛素甘精胰岛素治疗12周后血糖水平的差异。方法纳入2012年1月~2013年1月北京军区总医院新诊断2型糖尿病患者48例,随机分为单药治疗组（n=24）及联合治疗组（n=24）,单药治疗组仅餐前口服瑞格列奈（初始计量0.5 mg）,联合治疗组除餐前服用瑞格列奈外,每晚8 pm皮下注射甘精胰岛素（初始计量6 u）。根据血糖水平调整用药剂量,治疗12周后观察两组空腹静脉血糖（FBG）水平、餐后2小时血糖（2 hPBG）水平、糖化血红蛋白（HbA1c）水平及血糖达标时间。结果与单药治疗组相比,联合治疗组FBG[（5.9±1.6）mmol/L vs.（6.8±1.5）mmol/L]、2 hPBG[（8.8±0.9）mmol/L vs.（9.2±0.8）mmol/L]、HBA1c[（7.4±0.5）% vs.（7.8±1.3）%]均更低,且血糖达标时间明显缩短[（6.1±1.3）d vs.（8.9±2.5）d]。结论胰岛素促泌剂与长效胰岛素联合治疗2型糖尿病初始治疗较单独应用胰岛素促泌剂效果更好,并能促使血糖尽快达标。     

A comparison of glycemic effects of glimepiride, repaglinide, and insulin glargine in type 2 diabetes mellitus during Ramadan fasting

Although diabetics may be exempted from Ramadan fasting, many patients still insist on this worship. Aim of the present study is to compare the effects of glimepiride, repaglinide, and insulin glargine in type 2 diabetics during Ramadan fasting on the glucose metabolism. Patients, who were willing to fast, were treated with glimepiride (n=21), repaglinide (n=18), and insulin glargine (n=10). Sixteen non-fasting control type 2 diabetics matched for age, sex, and body mass index were also included. Fasting blood glucose (FBG), post-prandial blood glucose (PBG), HbA1c, and fructosamine as well as lipid metabolism were evaluated in pre-Ramadan, post-Ramadan, and 1-month post-Ramadan time points. There was no significant change from pre-Ramadan in FBG, PBG, and HbA1c variables in fasting diabetics at post-Ramadan and 1-month post-Ramadan. However, PBG was found higher in non-fasting control diabetics at post-Ramadan and 1-month post-Ramadan (p<0.05 and p<0.001, respectively). In fructosamine levels, a significant increase was noted both in fasting group and non-fasting group at 1-month post-Ramadan (p<0.01 for all). However, no significant difference was found in the comparison of the changes in fructosamine levels between fasting group and non-fasting group. Risk of hypoglycemia did not significantly differ between fasting and non-fasting diabetics. There was no significant difference between three drug therapies regarding glucose metabolism and rate of hypoglycemia. No adverse effects on plasma lipids were noted in fasting diabetics. In this fasting sample of patients with type 2 diabetes, glimepiride, repaglinide, and insulin glargine did not produce significant changes in glucose and lipid parameters.     

甘精胰岛素与瑞格列奈联用治疗2型糖尿病的临床研究

目的 观察甘精胰岛素联合瑞格列奈治疗2型糖尿病临床疗效.方法 常规治疗糖尿病基础上,对照组早晚餐前30min注射诺和灵30R 0.3～1.0U·kg-1·d-1;观察组每餐前15min口服瑞格列奈1mg,3次/d,根据餐后2h血糖每3d调整瑞格列奈量,最大量为4mg,3次/d;每晚睡前注射甘精胰岛素,起始剂量为0.1U·kg-1·d-1,剂量均根据患者的病情进行个体化调整.治疗前后测定两组患者空腹血糖、早餐后2h血糖及糖化血红蛋白(HbA1c)水平;观察胰岛素用量、体质量和BMI、低血糖事件发生率及安全性指标.结果 观察组患者空腹血糖、早餐后2h血糖、胰岛素用量、体质量和BMI、低血糖事件发生明显改善,优于对照组,未见明显不良反应.两组总有效率比较,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2型糖尿病临床疗效良好,值得推广.     

The effect of glargine versus glimepiride on pancreatic β-cell function in patients with type 2 diabetes uncontrolled on metformin monotherapy: open-label,randomized, controlled study

The aim of present study is to assess whether if basal insulin, glargine, could improve insulin secretory function of β-cells compared with glimepiride when metformin alone was failed. This was an open-label and multi-center study for 52 weeks in Korean patients with uncontrolled type 2 diabetes by metformin monotherapy. Subjects were randomized to glargine or glimepiride groups (n = 38 vs. 36, respectively). The primary endpoint was to compare changes in c-peptide via glucagon test after 48 weeks. Glycemic efficacy and safety endpoints (glycated hemoglobin (HbA1c), HOMA-B, fasting plasma glucose (FPG), lipid profiles, and hypoglycemic events) were also checked. The mean disease duration of all subjects was 88.2 months. Changes in C-peptide was no significant different between groups (P = 0.73), even though insulin secretion was not worsened in both groups at the endpoint. Glargine was not superior to glimepiride in other β-cell function indexes such as HOMA-B (P = 0.28). HbA1c and FPG reduced significantly in each groups but not different between two groups. Although, severe hypoglycemia did not occur, symptomatic hypoglycemia was more frequent in glimepiride group (P = 0.01). Insulin glargine was as effective as glimepiride in controlling hyperglycemia and maintaining β-cell function in Korean patients with type 2 diabetes during 48 weeks study period, after failure of metformin monotherapy. Hypoglycemic profile was favorable in the insulin glargine group and less weight gain was observed in the glimepiride group. Our results suggest that glargine and glimepiride can be considered after failure of metformin monotherapy.     

瑞格列奈联合阿卡波糖治疗2型糖尿病的临床效果及HbA1c、FPG、2 hPG水平影响评价

目的分析瑞格列奈联合阿卡波糖治疗2型糖尿病的临床效果及对HbA1c、FPG、2 hPG水平的影响。方法该次研究中的88例观察对象均抽选于2019年4月—2020年4月在该院接受治疗的2型糖尿病患者当中。应用数字随机分组的方式将患者分为两组,对照组患者接受瑞格列奈联合盐酸二甲双胍治疗,观察组患者给予瑞格列奈联合阿卡波糖,两组患者均接受为期3个月的用药治疗,比较其血糖水平改善情况、临床疗效以及不良反应发生情况。结果治疗前,观察组和对照组患者的空腹血糖(FPG)、餐后2 h血糖(2 hPG)以及糖化血红蛋白(HbA1c)水平相比,差异无统计学意义(P>0.05),治疗后观察组患者的空腹血糖、餐后2 h血糖和糖化血红蛋白均明显低于治疗前和对照组,差异有统计学意义(P<0.05);观察组患者的临床总好转率相比较于对照组,明显更高,差异有统计学意义(P<0.05);观察组患者的不良反应发生率与对照组相比较,差异无统计学意义(P>0.05)。结论瑞格列奈联合阿卡波糖治疗2型糖尿病的临床疗效显著,可有效控制患者的血糖水平,且安全性较高。     

Prandial insulin substitution with insulin lispro or insulin lispro mid mixture vs. basal therapy with insulin glargine: a randomized controlled trial in patients with type 2 diabetes beginning insulin therapy

PURPOSE: To compare the effects of prandial insulin therapy focusing on postprandial glucose control vs. basal insulin therapy focusing on fasting glucose control in patients with type 2 diabetes. METHODS: This was an open-label, randomized, parallel, three-arm multicenter trial in patients with type 2 diabetes starting insulin treatment. Patients (n=159) were randomly assigned to 24-week treatment with 3x daily insulin lispro, 3x daily lispro mid mixture (MidMix; 50% lispro, 50% protaminated lispro), or 1x daily insulin glargine; oral antihyperglycemic agents were discontinued. Primary end point was the postprandial glucose excursion 2 h after breakfast at the end of study. Secondary outcomes included HbA1c, self-monitored blood glucose profiles, hypoglycemic episodes, body weight, and patient satisfaction. RESULTS: At the end of study, glucose excursions 2 h after breakfast were significantly lower with lispro and MidMix than with glargine (P<.001 for each vs. glargine): lispro, -0.6+/-2.0 mmol/l; MidMix, +0.8+/-2.4 mmol/l; glargine, +2.5+/-2.4 mmol/l. Fasting glucose decreases were significantly greater with glargine (-2.6+/-2.4 mmol/l) than with lispro or MidMix (-0.9+/-2.2 mmol/l; +0.9+/-1.8 mmol/l). Nevertheless, HbA1c decreased by 1.1% (lispro) and 1.2% (MidMix), vs. 0.3% with glargine. Hypoglycemic episodes were rare with 1-1.5 self-reported episodes per 100 patient-days. CONCLUSIONS: In patients with type 2 diabetes starting insulin, 3x daily prandial treatment with a rapid-acting analog focusing on postprandial glucose values enabled better control of postprandial and circadian blood glucose profiles than once-daily glargine, in spite suboptimal fasting glucose levels, which targets fasting glucose values. These results support studies suggesting that control of postprandial hyperglycemia plays a key role in achieving HbA1c targets.     

在2型糖尿病治疗中甘精胰岛素联合瑞格列奈的应用安全性分析

目的 评价对2型糖尿病患者应用甘精胰岛素联合瑞格列奈的临床价值以及安全性分析.方法 选取时间为2017年9月—2019年4月,对该医院收治的138例2型糖尿病患者开展研究,采用数字随机表法将其平均分成2组(实验组与参照组),每组69例.其中参照组运用诺和灵30R治疗,实验组运用甘精胰岛素联合瑞格列奈治疗.对其治疗前后血...     

甘精胰岛素联合瑞格列奈治疗老年2型糖尿病患者的疗效与安全性

目的 观察甘精胰岛素注射液联合口服降糖药物瑞格列奈对老年2型糖尿病患者的血糖控制情况和低血糖的风险. 方法 选择口服降糖药物血糖控制不良的老年2型糖尿病患者64例,随机分为甘精胰岛素组(简称甘精组)和预混胰岛素组(诺和灵30R,简称预混组),每组各32例.甘精组在每天3餐前口服瑞格列奈的基础上,每晚22时注射甘精胰岛素1次;预混组每天早、晚餐前分别注射诺和灵30R预混胰岛素;根据空腹血糖及餐后血糖的水平,每3天调整瑞格列奈及胰岛素剂量,以空腹血糖<7.2 mmol/L,餐后血糖<10.0 mmol/L为治疗目标,共治疗16周,观察血糖控制和低血糖发生情况. 结果 治疗16周后两组的全天血糖谱和糖化血红蛋白(HbAlc)有明显下降(P<0.05),甘精组全天各时点血糖均值低于预混组,其中午餐后、晚餐后2 h血糖与预混组比较,差异有统计学意义(均为P<0.05),甘精组HbAlc值明显低于预混组(P<0.05);体质指数(BMI)甘精组无明显增加(P>0.05),预混组BMI较治疗前明显增加(P相似文献   

Long-term efficacy of insulin glargine after switching from NPH insulin as intensive replacement of basal insulin in Japanese diabetes mellitus. Comparison of efficacy between type 1 and type 2 diabetes (JUN-LAN Study 1.2)

To assess and compare the efficacy and safety of insulin glargine as intensive replacement of basal insulin in Japanese patients with type 1 (n = 72) and type 2 (n = 46) diabetes, we switched their intensive insulin regimen from NPH plus regular or rapid-acting insulin to glargine plus bolus insulin, which included regular and rapid-acting insulin, and recorded changes in glycemic control and frequency of hypoglycemia for 18 months. The dose titration of basal and bolus insulin was based on home self-monitored blood glucose measurements and monthly HbA(1C). Mean HbA(1C) level was improved significantly at 3 months after switching to glargine plus bolus insulin regimen and these effects continued for 18 months in both type 1 and type 2 diabetes patients (HbA(1C) level: type 1: baseline 8.9 +/- 2.6%, 18 months 7.8 +/- 1.5% (p<0.05), type 2: baseline 8.2 +/- 2.6%, 18 months 7.7 +/- 1.5%. Body weight was slightly but significantly increased at 18 months only in type 2 diabetes. Total daily bolus insulin doses were not changed but basal insulin could be increased significantly after switching regimens in both types diabetes compared with baseline. The frequency of mild to moderate hypoglycemia (self-assisted episodes, blood glucose <70 mg/dl) was marginally lower with glargine but not significantly. Self-monitored fasting blood glucose level was significantly improved after switching in type 2 diabetes. Patients with the worst HbA(1C) level at baseline exhibited more than 10% improvement in HbA(1C) level after switching both type 1 and type 2 diabetes. The HbA(1C) levels of the effectively treated patients were comparable to those of ineffectively treated ones at 6 months and the same improvement was seen at 18 months. Our results suggested that insulin glargine is more effective than NPH insulin as intensive replacement of basal insulin, particularly in those Japanese patients with difficult glycemic control with NPH insulin, equally in both type 1 and type 2 diabetes.     

Efficacy and treatment satisfaction of once-daily insulin glargine plus one or two oral antidiabetic agents versus continuing premixed human insulin in patients with type 2 diabetes previously on long-term conventional insulin therapy: the Switch pilot study.

BACKGROUND: Addition of the long-acting basal human insulin analogue insulin glargine (LANTUS) to the treatment regimen of patients with inadequate glycaemic control on oral antidiabetic drugs (OADs) alone has previously been evaluated as effective, safe and convenient. This pilot study aimed to establish whether insulin glargine plus OADs is effective in Type 2 diabetes patients previously poorly controlled on premixed insulin therapy. METHODS: In an open, controlled, randomized, parallel-group, single-centre, 16-week pilot study, 52 patients (age 65.6+/-9.2 years; diabetes duration 15.3+/-7.6 years; insulin therapy duration 4.2+/-1.7 years, body mass index 31.4+/-2.9 kg/m2) with Type 2 diabetes (HbA1c>or=8.0%) on premixed human insulin (75/25 or 70/30) were randomized to once-daily morning insulin glargine plus glimepiride (Group A; n=17), insulin glargine plus glimepiride and metformin (Group B; n=18) or premixed insulin (Group C; n=17). Glycaemic control and incidence of hypoglycaemia were evaluated. RESULTS: HbA1c decreased significantly from baseline in Groups A and B, but not in Group C; (Group A: 7.87+/-0.66%, -0.35%, p=0.013; Group B: 7.44+/-0.92%, -0.69%, p=0.0057; Group C: 7.83+/-1.13%, -0.25%, p=0.32). There were no between-treatment differences at endpoint in HbA1c, fasting blood glucose, mean daily blood glucose or symptomatic hypoglycaemia (mean events/patient: Group A, 2.2; Group B, 2.3; Group C, 2.0). At endpoint, 88% of patients in Group A, 81% in Group B and 94% in Group C opted to continue with their assigned regimen. CONCLUSIONS: This pilot study is the first prospective study to show that switching from premixed insulin to insulin glargine plus OAD treatment resulted in similar glycaemic control and treatment satisfaction. The results support the need for prospective examination in a larger-scale clinical study in patients with long-standing Type 2 diabetes and sub-optimal glycaemic control previously using a conventional premixed insulin regimen.