格列本脲联合二甲双胍长期治疗对2型糖尿病患者胰岛素抵抗的影响

目的探讨格列本脲联合二甲双胍对2型糖尿病（T2DM）患者糖代谢和胰岛素功能的影响。方法选取我院门诊病人61例,分为格列本脲治疗（格列本脲组,n=32）和格列本脲＋二甲双胍治疗（格列本脲＋二甲双胍组,n=29）,格列本脲组为初诊病人;格列本脲＋二甲双胍组在保持平时服用二甲双胍的剂量不变的基础上加用格列本脲。随访24周,每4周根据空腹血糖（FBG）调整剂量,治疗前后做血脂、血糖、胰岛素、C肽测定,并计算胰岛素抵抗指数（HOMA-IR）。结果两组患者治疗后HbAlc较治疗前均显著降低（均P〈0.01）。格列本脲＋二甲双胍组治疗后FIns和HOMA-IR较治疗前均有显著降低（均P〈0.05）。结论格列本脲单用或与二甲双胍合用都能有效降低血糖,并没有明显的胰岛β细胞功能损害。但在改善胰岛素抵抗方面,两者联用效果更优。

Effect of daonil combined with metformin on insulin resistance of type 2 diabetic patients

Objective To investigate the effect of daonil combined with metformin on glycometabolism and insulin function of type 2 diabetic patients.Methods 61 patients with type 2 diabetes from out-patient clinic were enrolled into a 24 week study.Among these patients,32 subjects who received daonil,another 29 subjects received daonil plus metformin which retained the same doses in normal time.The doses of daonil were adjusted through fasting blood glucose levels every 4 weeks.The levels of blood fat,plasma glucose,plasma insulin,C peptide were assayed before and after treatment,and HOMA-IR was also calculated.Results At the end of treatment,the levels of HbAlc in two groups were significantly reduced（all the P〈0.01）,and the levels of fasting plasma insulin and HOMA-IR were obviously decreased too（all the P〈0.05）.Conclusion Daonil alone or daonil plus metformin can decrease plasma glucose levels,rather than obviously damage the function of pancreatic beta cells.While daonil plus metformin is somewhat better than daonil in improving insulin resistance.