胰岛素联合用药治疗碘脲类继发性失效临床观察

①目的探讨胰岛素联合用药治疗磺脲类(SU)继发性失效临床疗效.②方法SU继发性失效糖尿病病人34例,随机分为A,B两组,A组采用SU与中效胰岛素(NPH)联合,B组采用二甲双胍与NPH联合治疗84d.③结果A,B两组治疗达标率差异无显著性(P=0.328),治疗达标时间B组长于A组(t=14.32,P＜0.01),B组NPH用量＞A组(t=4.61,P＜0.05),B组低血糖反应次数小于A组(f=5.27,P＜0.05).空腹血糖、餐后2h血糖、糖化血红蛋白两组均明显下降.④结论SU继发性失效中部分病人并非真正失效而是功能障碍,用SU和双胍类联合NPH仍能取得良好疗效.

COMBINATION TIHERAPY WITH INSULIN FOR FAILURE FOLLOWING SULFONYLUREA THERAPY IN DIABETES

Objective To observe the clinical effect of combined use of insulin for secondary failure to sulfonylurea(SU) treatment. Methods 34 patients with secondary failure to SU were randomly divided into two groups, 17 for each group. Group A was given SU and neutral protamine hagedorn(NPH),and Group B, metformin and NPH. Both groups were treated for 84 days. Results There was no significant difference in the rate of achieving the goal of treatment between the two groups(P=0.328). The time of attaining the goal for Group B was longer than that for Group A(t=14.32,P<0.01). NPH dose used in Group B was more than that in Group A(t=4.61,P<0.05).There was less hypoglycemia in Group B than in Group A(t=5.27,P<0.05). Fasting blood sugar and sugar 2 hours after breakfast and saccharified hemoglobin were significantly decreased in both groups after the treatment. Conclusion This study suggests that some patients with secondary failure to SU were not really failed to it ,but were due to poor function of pancreas. Good effects could still be achieved with the treatment by combination of SU, biguanidide and NPH.