甘精胰岛素联合口服药治疗初诊2型糖尿病临床观察

目的：观察甘精胰岛素联合瑞格列奈及二甲双胍治疗初诊2型糖尿病的临床疗效及安全性。方法：对40例初诊的2型糖尿病患者分为对照组20例和治疗组20例。所有患者均接受了同等糖尿病知识的教育,予饮食控制、运动治疗及血糖监测。对照组采用皮下注射预混胰岛素,2次/d;治疗组在口服瑞格列奈、二甲双胍的基础上加用甘精胰岛素皮下注射,1次/晚,疗程均为12周。12周后比较两组治疗前后组内及组间的FPG、2hPG、HbAlc、BMI及低血糖频率、程度等情况。结果：治疗前两组患者各项观察指标差异无统计学意义（P〉0.05）,治疗后两组患者FPG、2hPG、HbAlc显著下降,比较差异有统计学差异（P〈0.05）;BMI具有增加趋势,但对照组增加更明显;治疗组低血糖频率低于对照组,比较差异有统计学意义（P〈0.05）。结论：联合应用甘精胰岛素、瑞格列奈、二甲双胍治疗初诊2型糖尿病有较好的疗效,且不良反应较少,患者依从性好,值得临床推广。

Effect of Insulin Glargine Combined with Oral Antidiabetic Drugs on Treatment in Newly Diagnosed Type 2 Diabetes Mellitus

Objective：To observe the effect and safety of therapy of insulin glargine combined with repaglinide and metformin in newly diagnosed patients with type 2 diabetes mellitus.Method：40 cases with newly diagnosed type 2 diabetic mellitus were randomized into the control group and the treatment group.All patients received the same education of diabetes,diet control,exercise therapy and blood glucose monitoring.The control group was treated with premixed insulin for subcutaneous injection,2 times a day.The treatment group was combined with insulin glargine for subcutaneous injection,once a night,based on oral repaglinide and metformin.The therapeutic period was 12 weeks.FPG,2 h PG,HbAlc,BMI,hypoglycemia frequency,extent were compared within the same group and between the two groups before and after treatment.Result：Before treatment,the observed indicators of the two groups showed no statistically significant difference（P 0.05）.After treatment,FPG,2 h PG,HbAlc decreased significantly, the difference was statistically significant between the groups（P 0.05）.BMI had an increasing trend,but the control group increased more obviously. Frequency of hypoglycemia in treatment group was lower than the control group,the difference was statistically significant between the groups（P 0.05）. Conclusion：The therapy of insulin glargine combined with repaglinide and metformin in newly diagnosed type 2 diabetes mellitus has better curative effect and less adverse reaction while patient’s compliance is good.The therapy is worthy of clinical outreach.