胰岛素联合二甲双胍治疗老年2型糖尿病的临床效果

Clinical Effect of Insulin Combined with Metformin in the Treatment of Type 2 Diabetes Mellitus in the Elderly

目的:探讨胰岛素联合二甲双胍治疗老年2型糖尿病的临床效果及对患者血糖波动的影响。方法:选取2016年1月—2017年2月我院收治的50例老年2型糖尿病患者为研究对象,按随机数字表法分为研究组和对照组,各25例。对照组单纯应用二甲双胍(0.25 g,bid)治疗,研究组应用胰岛素(0.15 IU/kg治疗,睡前皮下注射,qd)联合二甲双胍(同对照组)治疗,比较两组血糖情况、临床血清指标、血液动力学指标及并发症发生情况。结果:治疗后研究组空腹血糖(FBG)、餐后两小时血糖(2 hPG)以及糖化血红蛋白(HbA1c)水平显著低于对照组,差异有统计学意义(P <0.05);治疗后研究组血浆黏度、全血黏度、血小板黏度显著低于对照组,差异有统计学意义(P <0.05);研究组体质量增加量、胰岛素用量、血糖达标时间、低血糖发生率低于对照组,差异有统计学意义(P <0.05);研究组并发症发生率显著低于对照组,差异有统计学意义(P <0.05)。结论:胰岛素与二甲双胍联合治疗老年2型糖尿病的效果显著,可降低并发症发生率,改善血流动力学指标,在临床上应该进一步推广应用。

Objective:To explore the clinical effect of insulin combined with metformin in the treatment of type 2 diabetes mellitus in the elderly and its effect on blood glucose fluctuations in the patients.Methods:50 elderly patients with type 2 diabetes mellitus admitted to our hospital from January 2016 to February 2017 were selected and divided into a study group and a control group according to the random number table method,25 cases each.The patients in the control group were treated with metformin(0.25 g,bid)alone,and the patients in the study group were treated with insulin(0.15 IU/kg,subcutaneous injection before bedtime,qd)and metformin(the same as the control group).The status of blood glucose,clinical serum indexes,hemodynamic indicators and complications were compared between the two groups.Results:After treatment,the levels of fasting blood glucose(FBG),postprandial two-hour blood glucose(2 hBG)and glycosylated hemoglobin(HbA1c)in the study group were significantly lower than those in the control group,with statistically significant differences(P<0.05).After treatment,the plasma viscosity,whole blood viscosity and platelet viscosity in the study group were significantly lower than those in the control group,with statistically significant differences(P<0.05).The gain of body mass,insulin dosage,time of blood glucose reaching the standard and hypoglycemia incidence in the study group were lower than those in the control group,with statistically significant differences(P<0.05).The incidences of complications in the study group were significantly lower than those in the control group,with statistically significant differences(P<0.05).Conclusion:Insulin combined with metformin in the treatment of type 2 diabetes mellitus in the elderly is effective,and can reduce the incidences of complications and improve hemodynamic indexes,and should be further promoted and applied in clinical practice.