胰岛素联合二甲双胍或吡格列酮治疗2型糖尿病的疗效观察

Effects of metformin or pioglitazone combining with insulin in type 2 diabetes mellitus

①目的探讨胰岛素联合应用二甲双胍或吡格列酮治疗2型糖尿病患者对胰岛素用量及血糖控制的影响。②方法对因口服降糖药治疗控制血糖效果不佳,改为单独应用胰岛素治疗的患者60例,随机分入胰岛素治疗组、胰岛素联用二甲双胍治疗组和胰岛素联用吡格列酮治疗组,治疗观察12周,比较治疗前后3组患者体重和HbA1 c、胰岛素用量及发生低血糖情况。③结果观察结束时,胰岛素联用二甲双胍组和胰岛素联用吡格列酮组其胰岛素用量均低于单纯胰岛素组(P<0.01,P<0.05),分别比胰岛素组减少24%和18%;HbA1 c水平和低血糖发生次数均亦低于胰岛素组(P<0.05),但各组间体重无差异(P>0.05)。④结论胰岛素联用二甲双胍或联用吡格列酮均可以节省胰岛素用量,而且可以更好地改善血糖,减少低血糖症的发生。

Objective To investigate whether mefformin or pioglitazone combined with insulin can reduce insulin dosage in type 2 diabetes mellitus（T2DM）, Method Sixty T2DM patients using insulin alone were randomly divided into 3 groups, insulin group who continued to use insulin alone, insulin plus metformin group and insulin plus pioglitazone group, insulin dosage, HbAlc, weight and hypoglycemia symptome were recorded at beginning and end of trial. Results Insulin dosage were lower in both insulin plus metfonnin group（ 36.6 ± 8.3U/d） and insulin plus pioglitazone group （40.2 ±9. 0U/d） than in insulin group（49.1 ± 11.5U/d） （P 〈 0.05, P 〈 0.01 respectively）. So were HbAlc level and hypoglycemia symptome（ all P 〈 0.05 ）. Conclusion Both pioglitazone and metformin have insulin -sparing effects when combined with insulin in T2DM.