不同胰岛素应用方案治疗初诊2型糖尿病的研究

Study on the effect of oral hyperglycemic agents in combination with insulin on type 2 diabetes patients.

目的探讨不同胰岛素应用方案治疗初诊2型糖尿病(T2DM)的疗效。方法50名初诊T2DM患者分为口服降糖药联合诺和灵N治疗(A)组、胰岛素强化治疗(B)组及口服降糖药治疗(C)组,比较其治疗前与治疗3个月后以及各组之间血糖、糖化血红蛋白(HbA1C)、HOMA-β指标的变化。结果A、B、C三种治疗方案控制血糖达标时间分别为(7.9±4.2)d、(5.8±3.1)d和(12.3±5.7)d,与治疗前比较,治疗后HbA1C均有下降(P<0.05),△HbA1CA组大于C组,与B组无差异;HOMA-β指数3组均有升高(P<0.01,P<0.01,P<0.05),A组与B组比较无差异,较C组升高明显(P<0.01)。结论口服降糖药联合中效胰岛素治疗能有效地控制初诊T2DM患者的血糖及部分恢复其胰岛β细胞功能;疗效与胰岛素强化治疗相近,优于单纯口服降糖药治疗。

Objective To investigate the therapeutic effect of bedtime NPH in combination wish OHAs on newly diagnosed type 2 diabetic patients. Methods 50 newly diagnosed type 2 diabetic patients were divided into three groups. Group A consisted of 20 eases, group B consisted of 10） eases and group C consisted of 20 cases were treated with NPH combined with OHAs, continuous subcutaneous insulin infusion（CSII） or multiple daily infusion（MDI） and OHAs for 3 months respectively. FBG, PBG, FINS and HbAI C were measured and HOMA - β in 3 groups was calculated before and after treatment. Results The time of glyeeamie control to the target in 3 groups was 7.9 ± 4.2 days,5.8 ± 3.1 days and 12.3 ± 5.7 days respectively. The HbA1C level was lower and HOMA - β value was higher in all 3 groups after treatment. The changes of HbA1C （△HbAIC） and HOMA- β after treatment were signifieanifiy higher in patients of group A compared with group C and there were no significant differences between group A and group B. Conclusion NPH combined with OHAs can effectively control the blood glucose and improve pancreatic β - cell function in newly diagnosed type 2 diabetic patients. The effect of combination therapy is similar to CSII or MDI and better than OHAs.