格华止联合胰岛素治疗经磺脲类药物治疗失效的2型糖尿病

Combining metformin with insulin in treatment of type 2 diabetes mellitus with sulfonylureas failure

目的观察格华止(二甲双胍)联合胰岛素对经磺脲类药物治疗失效的2型糖尿病患者的疗效和安全性。方法60例磺脲类药物治疗失效的2型糖尿病患者随机分为2组:格华止联合胰岛素组30例(甲组),每日2次预混人胰岛素(诺和灵30 R)皮下注射,格华止850 mg po qd;单用胰岛素组30例(乙组),每日2次预混人胰岛素皮下注射。根据血糖调整胰岛素用量。结果甲组治疗时起始胰岛素剂量及达到基本血糖控制时胰岛素剂量均显著低于乙组,差别有显著性(P<0.05)。治疗过程中乙组有3例出现低血糖反应,甲组有10例出现轻度的消化道症状。结论2型糖尿病磺脲类治疗失效患者格华止联合胰岛素治疗可有效控制血糖,胰岛素用量小,不良反应少。

Objective To observe the effect and security of combining mefformin with insulin in treatment of type 2 diabetes mellitus with sulfonylureas failure. Methods Sixty patients with type 2 diabetes mellitus were divided into two groups ： the first group （ group ： A） was treated by combining pre-mixed human insulin （Novolin 30R） with metformin （850 mg once a day） ;the second group （group B）was treated on-ly by insulin （Novolin 30 R）. The dosage of insulin was adjusted according to the level of blood glucose. Results The start isulin dosage and the effective insulin dosage in group A were significantly lower than that in group B （P 〈 0. 05 ）. There were 3 cases with low blood glucose reaction in group B and 10 cases with light gastro-intestinal symptom in group A. Conclusions Using insulin combined with mefformin is better than in-sulin alone in type 2 diabetes mellitus with sulfonylureas failure.