罗格列酮对胰岛素治疗不佳的2型糖尿病病人疗效及安全性评价

目的：观察罗格列酮对胰岛素治疗后血糖控制不良的2型糖尿病(2-DM)病人的疗效及安全性。方法：64例胰岛素治疗后血糖控制不良的2-DM病人分为罗格列酮组(R组)和对照组(C组)，随访12周，观察血糖、糖化血红蛋白、体重、血压、血脂、血常规、肝肾功能以及平均日胰岛素用量等变化。结果：R组血糖水平在治疗第2周起即出现显下降，第12周时有18例病人(58．1％)空腹血糖降至7．0mmol／L以下；HbA1c在6～12周后才有明显降低，至第12周时降幅为1．5％；第12周时，R组平均日胰岛素用量较初访时减少18U，而C组则较初访时增加lOU；R组最常见的不良反应为低血糖和下肢水肿，发生率分别为45．2％和9．7％，均较C组有显差异。结论：罗格列酮能有效地在减少每日胰岛素用量的基础上降低胰岛素治疗后血糖控制不良的2一DM病人的血糖水平，但应注意水肿和联合治疗时的低血糖现象。

Efficacy and safety of rosiglitazone in type 2 diabetic patients who were poorly controlled by insulin

Objective: To evaluate the efficacy and safety of rosiglitazone in type 2 diabetic patients who were poorly controlled by insulin. Methods: Sixty four diabetic patients who were poorly controlled by insulin were divided into 2 groups, rosiglitazone(R) group and control(C) group. Clinical variables such as blood glucose, glycohemoglobulin(HbA 1C ), body weight, blood pressure, blood lipids, blood routine, biochemical index and insulin dosage per day were observed for each patient. Results: Blood glucose of group R significantly decreased since the 2nd week after treatment. In the 12th week, the fasting plasma glucose in 18 patients (58.1%) reached lower than 7.0 mmol/L. HbA 1C went down slowly in group R and showed great decrease only after the 6th week. In the 12th week, the mean dosage of insulin per day reduced by 18 units in group R, while increased by 10 units in group C. The main adverse effects of rosiglitazone were hypoglycemia and edema of lower extremities, with incidence of 45.2% and 9.7% respectively. Conclusion: Rosiglitazone can effectively decrease the blood glucose and HbA 1C and significantly reduce the insulin dosage per day in type 2 diabetic patients poorly controlled by insulin.