甘精胰岛素联合口服降糖药治疗2型糖尿病的临床观察

目的 观察甘精胰岛素联合口服降糖药对单纯口服药物治疗血糖控制不佳的2型糖尿病患者的治疗效果.方法 选择我院2016年1～6月收治的血糖控制不佳的2型糖尿病患者80例,随机分为实验组和对照组,实验组采用甘精胰岛素联合二甲双胍和吡格列酮治疗,对照组采用预混胰岛素注射治疗,患者均每周进行随访,持续观察3个月.监测患者治疗前后空腹血糖、餐后2h血糖和糖化血红蛋白等指标的变化,并对比患者治疗前后的血脂指标和体重.观察并记录患者的不良反应.结果 治疗3个月后,实验组空腹血糖(5.31±1.12)mmol/L vs.(6.48±1.09)mmol/L]、餐后2h血糖(7.46±1.08) mmol/Lvs.(8.21± 1.46) mmol/L]、糖化血红蛋白(5.39±0.98)％vs.(6.03±1.04)％]较对照组均明显降低,差异有统计学意义(P＜0.05);2组血脂指标、BMI的差异无统计学意义(P＞0.05).治疗过程中,实验组轻微低血糖事件3例,对照组轻微低血糖时间8件,夜间低血糖时间5例,2组均无低血糖昏迷发生,2组不良反应发生情况比较差异有统计学意义(x2=7.813,P=0.005).结论 对于单纯药物治疗血糖控制不佳的2型糖尿病患者,合理使用甘精胰岛素联合口服降糖药进行治疗,对控制血糖具有明显的效果,且低血糖发生率低.

Clinical observation on treatment of type 2 diabetes with insulin glargine combined with oral hypoglycemic agent

Objective To observe the therapeutic effect of insulin glargine combined with oral hypoglycemic agents on type 2 diabetes patients with poor oral glucose control.Methods 80 patients with type 2 diabetes with poor glycemic control who were admitted to our hospital from January to June in 2016 were randomly divided into experimental group and control group.The experimental group was treated with insulin glargine combined with metformin and pioglitazone,and the control group was premixed.Insulin injection therapy,patients were followed up every week for 3 months.The changes of fasting blood glucose,postprandial blood glucose and glycosylated hemoglobin were monitored before and after treatment,and the blood lipids and body weights before and after treatment were compared.Patient's adverse reactions were observed and recorded.Results After 3 months of treatment,the fasting blood glucose (5.31 ± 1.12) mmol/L vs.(6.48± 1.09) mmol/L] and 2 h postprandial blood glucose (7.46± 1.08) mmol/L vs.(8.21 ± 1.46 mmol/L] and HbA1c (5.39±0.98)％ vs.(6.03± 1.04)％] of the experimental group were significantly lower than those in the control group.The difference was statistically significant (P ＜ 0.05).There was no statistical difference between two groups in the blood lipids and body weights(P ＞ 0.05).During the course of treatment,there were 3 cases of slight hypoglycemic events in the experimental group,8 cases of mild hypoglycemia and 5 cases of nocturnal hypoglycemia in the control group.No hypoglycemic coma occurred in both groups.The difference in incidence of adverse reactions between the two groups was statistically significant(x2=7.813,P =0.005).Conclusion For patients with type 2 diabetes with poor drug control and blood glucose control,the rational use of insulin glargine combined with oral hypoglycemic agents has obvious effects on blood glucose control and low incidence of hypoglycemia.