睡前中效胰岛素与格列美脲联合治疗2型糖尿病磺脲类继发失效的疗效观察

目的：观察磺脲类继发失效（SFS）的2型糖尿病（T2DM）患者在改用格列美脲联合中效胰岛素（NPH）治疗后的临床疗效。方法：30例SFS的T2DM患者，在控制饮食基础上，停用原口服降糖药，改用口服格列美脲，睡前皮下注射NPH，观察治疗前后血糖、糖化血红蛋白（HbAlc）、胰岛素（Ins）、甘油三酯（TG），体质量指数（BMI）。结果：口服格列美脲联合睡前皮下注射NPH，治疗后FBG、2hBG、Ins较治疗前明显下降（P〈0．01），HbAlc、TG较治疗前下降（P〈0．05）。结论：格列美脲联合NPH治疗2型糖尿病磺脲类继发失效，可起到显著改善糖代谢及胰岛B细胞功能的作用．值得临床应用。

Observation of Therapeutic Effects of Combination Therapy of Bedtime Insulin( NPH)and Glimepiride on Type 2 Diabetic Mellitus with Secondary Failure of Sulfonylurea

Objective：To observe the clinical efficacy of combination therapy of glimepiride and bedtime insulin（NPH）on type 2 diabetic mellitus （T2DM）with the secondary failure of sulfonylurea （SFS）. Methods：30 cases T2DM with SFS stopped the original oral-administered hypoglyeemic drugs,in substitution,glimepiride was administered orally and NPN was injected subcutaneously at bedtime. Before and after treatment, plasma glucose （PG）, HbAlc, insulin （Ins）, triglyeeride （TG）and body mass index （BMI）were measured. Results：After treated with combination therapy of oral administration of glimepiride and subcutaneous injection of NPH at bedtime, PG, 2 hPG and Ins were all reduced apparently compared with those before treatment（P〈0.01）, HbAle and TG were reduced compared with those before treatment（P〈0.05）. Conclusion： For type 2 diabetic mellitus with the secondary failure of sulfonylurea, the combination therapy of glimepiride and NPH can significantly improve glyeometabolism and pancreas beta-cell function, it is worth to be applied in clinic.