甘精胰岛素联合二甲双胍或／和阿卡波糖治疗新诊断2型糖尿病疗效观察

目的比较甘精胰岛素联合二甲双胍或／和阿卡波糖治疗新诊断2型糖尿病的临床疗效及安全性。方法84例新诊断2型糖尿病患者先服用二甲双胍至少4周，血糖控制不佳的患者随机分为三组。A组予二甲双胍加甘精胰岛素，B组予阿卡波糖加甘精胰岛素，C组予二甲双胍与阿卡波糖加甘精胰岛素治疗，随访12周。结果三组治疗后空腹血糖（FBG）、餐后2h血糖（2hBG）、糖化血红蛋白（HbAlc）均低于治疗前治疗，A、B两组HbAlc部分达标，C组HbAlc全部达标（P〈0．05）。C组疗效优于A、B组，达标时间最短，日胰岛素用量最少。A、B组BMI无增加，C组BMI有所下降（P〉0．05）。三组低血糖发生率均〈11％，无严重低血糖事件发生，差异无统计学意义（P〉0．05）。结论甘精胰岛素联合二甲双胍或／和阿卡波糖均能较好地控制血糖，对体质量影响小，低血糖发生率低，三药联合疗效优于二药联合，总体安全、有效、方便，是新诊断2型糖尿病理想的治疗方案。

The effect of Glargine insulin combined with Metformin or/and Acarbose in treatment for the newly diagnosed type 2 diabetes

Objective To compare the clinical effects and safety of treating newly diagnosed type 2 diabetes patients by combining Glargine insulin with Metformin or/and Acarbose. Methods 84 patients with newly diagnosed type 2 diabetes ,who have a history of weight loss, body mass index( BMI )23 ～ 28kg/m2 and poorly controlled blood glucose in Metformin at least a month ,were randomly divided into three groups. Glargine insulin plus Mefformin were used in group A. Glargine insulin plus Acarbose(without mefformin)were used in group B, Glargine insulin, Acarbos and metformin were used in Group C. All three groups were given a 12-week follow-up. Results FBG,2hBG and HbA1c levels were lower in the patients after treatment( P ＜0. 05 ). HbA1c of patients was partly up to the standard in group A and group B,but HbA1c of patients was all up to the standard in group C. The effects in group C were better than those in group A and group B. It had the shortest time to achieve the target and the smallest dose of insulin in group C. BMI in group A and B did not change but decreased in group C(P＞0.05).The incidence of low blood sugar in all three groups was low and no significant difference observed among three groups (P＞0.05). And in all three groups no severe hypoglycemia occurred. Conclusion The method of combining Glargine insulin with Mefformin or/and Acarbose could effectively control blood sugar had little impact on body weight of the newly diagnosed type 2 diabetes patients, and moreover, the incidence of low blood sugar in the newly diagnosed type 2 diabetes patients was lower. It would be the ideal method to treat newly diagnosed type 2 diabetes patients considering the general safety and effectiveness and convenience.