甘精胰岛素联合格列美脲片治疗2型糖尿病的疗效观察

目的 探讨甘精胰岛素联用格列美脲片治疗磺脲类药物继发性失效的2型糖尿病患者的疗效及安全性.方法 60例口服磺脲类降糖药血糖控制不理想的2型糖尿病患者随机分为甘精胰岛素治疗组(GL组)和中性鱼精蛋白锌胰岛素(NPH)组,予睡前皮下注射胰岛素联合口服格列美脲治疗12周,观察12周前后空腹血糖、餐后2h血糖、糖化血红蛋白、空腹C肽、餐后C肽的变化.结果 GL组治疗后FPG(6.3±1.4)mmol/L,2hPG(8.7±1.4)mmol/L,HbAlc(6.7±0.61%;NPH组治疗后FPG(6.4±1.0)mol/L,2hPG(8.8 4±1.2)mmol/L,HbAlc(6.6±0.7)%,较治疗前差异有极显著性(P<0.01);但GL组的低血糖事件明显少于NPH组(P<0.05).且GL组治疗后C肽水平明显升高.结论 甘精胰岛素联用格列美脲片治疗2型糖尿病的方案安全有效,简便易行,能减少低血糖事件的发生,且可能改善胰岛功能.

Efficacy of insulin glargine plus glimepiride for type 2 diabetes mellitus

Objective To investigate the efficacy and safety of insulin glargine plus glimepiride in the treatment of type 2 diabetic patients. Methods Sixty patients poorly responsive to oral sulfonylureas were randomly assigned to receive oral glimepiride plus injections of either insulin glargine (GL group, 30 patients) or neural protamine hagedorn (NPH group, 30 patients) for 12 weeks. Levels of fasting blood glucose and C-peptide, postprandial blood glucose and C-peptide, and HbAlc were detected 12 weeks after treatment. Results The fasting and postprandial blood glucose levels were significantly decreased. The incidence of hypoglycemia was lower in GL group than in NPH group (P<0.05) and C-peptide level was markedly higher. Conclusions Combination therapy with insulin glargine and glimepiride for type 2 diabetes is safe, effective, simple, and feasible. It can reduce the incidence of hypoglycemia and improve pancreatic function.