甘精胰岛素联合二甲双胍治疗2型糖尿病患者的有效性和安全性

目的：了解甘精胰岛素联合二甲双胍治疗对口服降糖药血糖控制不理想的2型糖尿病患者的疗效和安全性。方法：对30例口服降糖药血糖控制不理想的2型糖尿病患者给与甘精胰岛素联合二甲双胍治疗,共12周。治疗前后测身高、体重、空腹血糖（FPG）、餐后2小时血糖（PPG）以及糖化血红蛋白（HbA1c）水平。了解治疗期间低血糖发生情况。结果：治疗后的FPG、PPG以及HbA1c水平明显下降,分别下降了3.03mmol/L、5.10mmol/L和1.98%,差异有统计学意义（P〈0.05）。治疗后53.30%的患者HbA1c水平〈7.0%。治疗前HbA1c水平≥7.0%-〈9.0%的患者,治疗后70.6%的患者HbA1c水平〈7.0%,治疗前HbA1c水平≥9.0%的患者,治疗后30.7%的患者HbA1c水平〈7.0%,两者的HbA1c达标率有明显差异（P〈0.05）。治疗前后体重及BMI无明显差异（P〉0.05）。30例患者中仅发生两次轻微低血糖。结论：甘精胰岛素联合二甲双胍治疗对口服降糖药治疗血糖控制不理想的2型糖尿病患者是安全有效的,尤其是对HbA1c水平〈9.0%的患者,血糖控制更好,达标率更高。

The Efficacy and Safety of the Combination of Metformin with Glargine in Type 2 Diabetic Subjects

Objective： To investigate the efficacy and safety of the combination of metformin with glargine in type 2 diabetic subjects with poor glycaemie control by oral antidiabetic drugs. Methods： Thirty patients were treated with glargine and met-formin for 12 weeks. Height, weight, fasting plasma glucose（FPG）, postprandial glueose（PPG） and HbAlc were measured before and after treatment. Hypoglycemia was also noted. Results： After treatment, the decrease of FPG was 3.03mmol/L, PPG was 5.10mmol/L and HbAlc was 1. 98%, individually, which were obviously lower than the baseline （P〈0. 05）. At the twelfth week, the percentage of HbAlc〈7% was 53.3%. The percentage of HbAlc〈7% was 70.60/00 in the patients whose HbAlc was between 7% and 9%, however, the percentage was only 30.7% in the subjects whose HbAlc was greater than 9% at the baseline, the difference was significant in the two groups（P〈0.05）. Before and after treatment, no difference were noted in weight and BMI（P〉0.05）. There were only twice phenomenon of hypoglycemia in the 30 subjects. Conclusion： The combination of metformin with glargine is a kind of safe and effective therapeutic choice for the type 2 diabetic subjects with poor glycaemic control by oral antidiabetic drugs, especially for the patients whose HbAlc levels are less than 9.0 %.