来得时联合二甲双胍与吡格列酮治疗2型糖尿病临床观察

Clinical observation of lantus(Glargine)combined with Metformin and Pioglitazone in the treatment of type 2 diabetic patients.

目的观察来得时(甘精胰岛素)联合二甲双胍、吡格列酮治疗2型糖尿病患者疗效及安全性。方法将口服降血糖药物血糖控制不佳的2型糖尿病患者随机分为两组,治疗组(来得时组)20例,对照组(诺和灵30R组)22例,来得时组给予睡前皮下注射1次,诺和灵30R组给予早晚餐前皮下注射各1次,两组均联合二甲双胍、吡格列酮,按照空腹血糖(FPG)调整胰岛素用量,治疗目标值FPG<7.0mmol/L,治疗时间12周。观察治疗前后空腹血糖、糖化血红蛋白(HbA1c)、体重变化、低血糖情况。结果治疗后两组患者的空腹血糖、餐后2h血糖均明显低于治疗前各组水平(P<0.05);诺和灵30R组血糖下降水平、BMI变化与来得时组无差异(P>0.05);来得时组低血糖发生率明显低于诺和灵30R组(P<0.01)。结论来得时和诺和灵30R均能使患者血糖达标,来得时组低血糖发生率明显低于诺和灵30R组,更安全、方便,患者依从性更高。

Objective To investigate the therapeutic and safety of lantus(Glargine) combined with Metformin and Pioglitazone in patients with type 2 Diabetes mellitus;Methods 42 type 2 diabetes patients inadequately controlled with oral antidiabetic drugs(OADs) were randomly divided into 2 group.The patients in therapeutic group were injected lantus (Glargine)at bedtime while the patients in control group were treated with Novonorm 30R(twice preprandial injection (morning and night)).Two groups were treated with Metformin and Pioglitazone.The insulin dose was titraed to achieve fasting capillary BG<7.0mmol / l.The course of treatment was 12 weeks.Fasting plasma glucose(FPG) and the changes of HbA1c,body weight,hypoglycemic event were evaluated before and after the treatment.Results FPG,2 hours postprandial glucose(2hPG) in both groups were significantly reduced as compared with those at baseline(P<0.05);The changes of blood level and body mass index(BMI) in both groups was similar(P>0.05).The occurrence of hypoglycemia in therapeutic group was obviously lower than in control group(P<0.01).Conclusion The plasma glucose in both groups could achieve the target goal.But Therapeutic group has lower occurrence of hypoglycemia,more safe,convenience, higher compliance.