甘精胰岛素联合口服降糖药治疗2型糖尿病磺脲类继发性失效临床观察

目的：探讨甘精胰岛素联合口服降糖药物（拜糖苹或二甲双胍）治疗继发性磺脲类药物失效的2型糖尿病的短期疗效。方法：46例继发性磺脲类药物失效的2型糖尿病患者随机分成两组，A组使用甘精胰岛素加拜糖苹或二甲双胍，B组使用中效胰岛素加拜糖苹或二甲双胍。所有患者均于治疗前、治疗后12周测定空腹血糖（FBG）、餐后2h血糖（2hBG）、糖化血红蛋白（HbAte）。结果：两组治疗3个月后，FBG、2hBG、HbA。。均较治疗前明显降低，对于空腹血糖的控制A组明显优于B组，有统计学意义（P＜0．05），且A组低血糖发生率明显低于B组（P＜0．05）。结论：甘精胰岛素联合口服降糖药治疗继发性磺脲类药物失效的2型糖尿病患者，可以良好地控制高血糖，且低血糖发生率低，安全而有效。

Combination therapy with insulin glargine for falure following sulfonylurea therapy in type 2 diabetes

Objective: To observe clinical effect of combined use of insulin glargine for secondary failure to sulfonylurea(SU) treatment.Methods: Forty-six patients with secondary failure to SU were randomly divided into two groups,23 for each group.Group A were given metform/arcabose and insulin glargine,and Group B,metform/arcabose and neural protamine hagedorn(NPH).Both group were treated for 12 weeks,and blood glucose,HbA_(1c) were analyzed. Results: Blood glucose and glycated ferrphemoglobin after insulin treatment were lower than that befor the treatment(P<0.05),fasting blood glucose(FBG) after treatment of group A is lower than that of group B(P<0.05),the incidence of hypoglycemia in group A is lower than that in group B(P<0.05). Conclusion: Insulin glargine can control high blood sugar well and the incidence of hypoglycemia is low,combination therpy with insulin glargine could have been used in the treatment of patients with secondary failure to sulfonylurea.