胰岛素短期强化治疗恢复磺脲类降糖药敏感性30例的效果分析

Short-term intensive insulin treatment and sensitivity of sulfonylureas

目的探讨胰岛素短期强化治疗恢复糖尿患者对磺脲类降糖药敏感性。方法30例门诊和急诊糖尿病患者,其中男12例,女18例,均使用常规剂量磺脲类药物,但血糖控制不良。应用双相门冬胰岛素30后血糖达到控制良好3个月,之后停用胰岛素,继续以前的口服药物的治疗。结果停用口服降糖药之前3个月内平均血糖为(5.7±0.7)mmol/L,餐后2h血糖或随机血糖为(14.2±7.2)mmol/L;应用胰岛素达标时空腹血糖为(9.4±7.5)mmol/L,餐后2h血糖为(7.2±1.4)mmol/L;应用胰岛素期间空腹血糖为(6.0±0.8)mmol/L,餐后2h血糖为(7.8±1.2)mmol/L;停用胰岛素时,空腹血糖为(6.1±0.6)mmol/L,餐后2h血糖为(7.7±1.3)mmol/L。在改用原来口服降糖药后,1个月平均空腹血糖为(6.5±0.5)mmol/L,餐后2h血糖为(8.1±0.8)mmol/L,与应用胰岛素前相比,血糖降低的差异均有统计学意义(P<0.05)。结论短期胰岛素强化治疗有可能恢复糖尿病患者对磺脲类药物敏感性。

Objective To research the effects of short - term intensive insulin treatment onre - ganing the sensitivityof sulfonylureas in diabetes patients. Methods Thirty patients form outpatient and emergency department,includ -ingl2male andl8 female, who took regular -dose sulfonylureas but was high blood glucose lever, were selected tosus - pend the sulfonylureas - treatment and were given theBLAsp30 to control the blood glucose level for three months, then they were stopped theBLAsp30 and took the same sulofnylureas used before. Results The average fasting blood glucose, （FBG） was （9.4 ± 7.5 ） mmol/Land the average postprandial2h boodglucose （ PG2h ） （ or random blood gloucose） was （ 14.2 ± 7.2） mmol/Lin3 months betore stopping the sulfonylureas. The average FBGwas （ 5.7 ± 0.7 ） mmol/ Land - PG2hwas （7.2 ± 1.4） mmol/L at the beginning of the insulin getting the blood glucose under control The average FBGwas （ 6.0 ± 0. 8 ） mmol/Land PG2hwas （7.8 ± 1.2） mmol/Lduring the insulin treatment, the averageFB ＊ Gwas （6.1 ± 0.6）mmol/LandPG2hwas（7.7 ±1.3 ）mmol/Lat the end of the insulin treatment The average FBGwas（6.5 ± 0.5） mool/LandPG2hwas（8.1±0.8）mool/Lwhen continuing the sulfonylureas treatment in one months. It increased significantly to compare the bloodglucose before the treatment of insulin to that after the treatment of insulin （P 〈 compare the blood glucose before the treatment of insulin to that after the treatment of（ P 〈 0.05）. Conclusion short -term intensive insulin treatment restores the patinents sensitiveess to sulfonylureas probbiy.