胰岛素加吡格列酮联合治疗磺脲类继发性失效2型糖尿病的疗效观察

目的比较胰岛素加吡格列酮联合治疗和单用胰岛素治疗磺脲类继发性失效2型糖尿病患者的疗效.方法将磺脲类继发性失效2型糖尿病患者62例随机分为两组,治疗组32例,每日早餐及晚餐前皮下注射人胰岛素诺和灵50R及服吡格列酮15～30 mg;对照组30例,每日单用人胰岛素诺和灵50R于早餐及晚餐前皮下注射,12周后评价两组患者空服及餐后2小时血糖、糖化血红蛋白(HbA1c)、胰岛素用量、体质量指数、血压、胰岛素分泌及血脂总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]变化情况.结果两组患者治疗后血糖均得到良好控制,但治疗组胰岛素日需求量明显低于对照组(P<0.01);治疗组血TG较对照组下降,而HDL-C较对照组升高(P<0.05);治疗组空腹及餐后2小时胰岛素分泌较对照组减少(P<0.05).结论磺脲类继发性失效2型糖尿病患者选用胰岛素加吡格列酮联合治疗优于单用胰岛素治疗.

Insulin and pioglitazone in combinative treatment to type 2 diabetes mellitus secondary failure to sulforylureas

Objective To compare the clinical efficacy of insulin and pioglitazone united treatment with single insulin treatment in type 2 diabetes mellitus patients secondary failure to sulforylureas(Sus).Methods Sixty-two cases of type 2 diabetics with secondary failure to Sus were randomly divided into two groups. Thirty-two patients were in united treatment group: subcutaneously injected human-insulin Novolin 50R before breakfast and supper,and also taking orally pioglitazone 15-30 mg a day. Thirty patients were in control group: subcutaneously injected human-insulin Novolin 50R before breakfast and supper.After 12 weeks, fasting blood glucose(FBG),postprandial 2 h blood glucose(2 h PBG),hemoglobin A 1C(HbA 1C), insulin dosage,body mass indax(BMI),blood pressure(BP) and effect of insulin secretion, and blood lipidtotal cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),Highdensity lipoprotein cholesterol(HDL-C)] of the two groups were evaluated.Results Blood glucose was under good control in both groups, insulin dosage daily was significantly lower(P< 0.01),TG declined in the united and HDL-C arose(P< 0.05),insulin secretion of FBG and 2 h PBG reduced(P< 0.05) in united treatment group.Conclusion Selecting insulin and pioglitazone in combinative treatment for type 2 diabetics secondary failure to Sus is superior to single insulin treatment.