瑞格列奈与二甲双胍对2型糖尿病胰岛功能的影响

Influence of Repaglinide and Metformin on insulin secretion in type 2 diabetes

目的观察瑞格列奈与二甲双胍对2型糖尿病胰岛功能的影响。方法将120例初诊2型糖尿患者分为2组,治疗组60例予瑞格列奈口服,强化组60例予瑞格列奈联合二甲双胍口服,比较2组治疗前后空腹血糖、餐后2 h血糖、餐后1 h及2 h血浆胰岛素变化及胰岛素曲线下面积的变化。结果治疗组餐后2 h血糖治疗后明显下降(P<0.05),餐后1 h血浆胰岛素明显升高(P<0.05)。强化组空腹血糖、餐后2 h血糖明显下降(P<0.05和0.01);餐后1h血浆胰岛素显著升高(P<0.01),餐后2 h血浆胰岛素降低,且显著低于餐后1 h血浆胰岛素(P<0.05)。结论瑞格列奈可改善胰岛素早期分泌时相,瑞格列奈与二甲双胍联合治疗可使2型糖尿病胰岛素早期分泌相恢复,餐后血糖控制良好。

Objective It is to observe the influence of Repaglinide and Metformin on insulin secretion in type 2 diabetes. Methods 120 cases of newly diagnosed type 2 diabetic patients were divided into two groups randomly： the treatment group （60 cases） was given Repaglinide by mouth, and the combined group （60 cases） was given combined Repaglinide and Met- formin by mouth. After treatment for 2 months, the fasting blood glucose （FBG） and postprandial 2 - hour blood glucose （2hPG） were observed in both groups, postprandial 1 - hour concentration of the serum insulin （PINSlh） and postprandial 2- hour concentration of the serum insulin （PINS2h）, the ratio of the area under curve of insulin level before and after therapy were observed and compared. Results In the treatment group, the level of 2hPG was decreased after therapy （P 〈 0.05）, and the level of PINS1h was increased significantly （P〈0.05）. In the combined group, the levels of FBG, 2hPG were decreased significantly（P〈0.05 and 0.01 ） ; and the level of PINS1h was increased significantly （ P 〈 0.01 ）, the level of PINS1h was decreased significantly （P 〈 0.05）. Conclusion Repaglinide can increase early insulin secretion, and when it is used combined with Metformin, the early insulin secretion is stronger and can control postprandial blood glucose well.