胰岛素联合二甲双胍或优降糖治疗2型糖尿病的疗效比较

目的探讨胰岛素联合二甲双胍或优降糖对单一磺酰脲类药物治疗失效的2型糖尿病的临床疗效。方法80例患者随机分为2组，均采用胰岛素治疗，一组加服二甲双胍，一组加服优降糖，观察治疗12周前后空腹血糖（FPG）、餐后2小时血糖（2hPG）、糖化血红蛋白（HbA1C）、体重指数（BMI）、血甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白（LDL-C）及高密度脂蛋白（HDL-C）的变化。结果两组FPG、2hPG、HbA1C均较治疗前明显下降，优降糖组BMI增高明显，二甲双胍组TG、TC、LDL-C降低有统计学差异。结论2组均能很好控制血糖，但联合二甲双胍在纠正血脂紊乱，避免体重增加等不良反应方面较联合优降糖更佳。

Effects of mefformin or glibenclamide combined with insulin in the patients with type 2 diabetes mellitus

Objective To evaluate the clinical effects of insulin combined with metformin or glibenclamide in the patients with type 2 diabetes mellitus(DM)whose plasma glucose controlled dissatisfactorily with sulphonylurea only.Methods 80 patients were randomly divided into two groups:metformin group and glibenclamide group,and both of the two groups used insulin.FPG,2hPG,HbA1C,BMI,TG,TC,LDL-C and HDL-C were observed at the beginning and the end of 12-week trial.Results The level of FPG,2 hPG,HbA1C were reduced significantly in both groups.BMI was increased significantly in glibenclamide group.TC,TG,LDL-C were reduced significantly in metformin group.Conclusion The two groups can both control plasma glucose of the patients with type 2 DM satisfactorily,but insulin combined with metformin is better than combined with gilbenclamide in improving lipid profile,avoiding weight gaining and other side effects.