甘精胰岛素联合口服降糖药控制空腹及餐后高血糖的研究

A study on the control of fasting and postprandial hyperglycemia by glargine insulin Combined with oral hypoglycemic agent

目的探讨甘精胰岛素与口服降糖药联用控制空腹及餐后高血糖的疗效。方法将136例单用口服降糖药血糖控制不理想的T2DM患者随机分为A、B两组。A组采用国产甘精胰岛素(长秀霖),B组采用进口甘精胰岛素(来得时),两组在用甘精胰岛素的基础上,均分别与二甲双胍和瑞格列奈联用,观察治疗前后FPG、2hPG及HbA_1c水平和低血糖的发生率。结果治疗后两周时FPG、2hPG及HbA_1c水平与治疗前相比均明显下降,但仍未达标。两组患者在甘精胰岛素和二甲双胍治疗的基础上加用瑞格列奈,治疗后4周时FPG及2hPG水平均已达标,HbA_1c水平于治疗2个月时达标。两组治疗后各项指标与治疗前相比均明显下降(P均<0.01),两组临床疗效无统计学差异,低血糖发生率分别为4.2%和4.6%,相比无统计学差异(P>0.05)。结论两种甘精胰岛素分别与二甲双胍和瑞格列奈联用,能较好控制FPG、2hPG及HbA_1c水平,低血糖发生率均较低,临床疗效相近。因此,甘精胰岛素与二甲双胍和瑞格列奈联用是控制FPG、2hPG及HbA_1c水平的安全有效的治疗方案。

Objective To investrgate the effect and safety on the control of fasting and postprandial hyperglycemia by glargine insulin combined with oral hyperglycemic agents （OHA）. Methods 136 T2DM cases with not well controlled hyperglycemia were divided randomly into group A and B. Group A and B patients received national glargine and imported glargine respectively in addition to OHA of metformin and repaglinide. Blood glucose target rate and the safety, as well as hypoglycemia rate were observed. Results Levels of FPG,2hPG and HbAlc were decreased in post-versus pre-treatment at 2 weeks of treatment. The levels of FPG and 2hPG reached targets at 4 weeks in both groups and HbAlc reached target at 2 months in the schedule of insulin plus OHA. At the end of the study,parameters were improved significantly （all P〈0.01） in both two groups and the differences between 2 groups showed no statistical significances（P〉0. 05）. Insidence rate of hypoglycemia were 4. 2 % and 4. 6 % in A and B group respectively（P〉0. 05）. Conclusions （1） Therapeutic effect is similar between imported and national glargine. （2） Combined glargine and metformin or repaglinied schedule is effective and safe.