甘精胰岛素联合二甲双胍在2型糖尿病强化治疗中的疗效分析

Analysis of Clinical Efficacy of Glargine Combining with Metformin in the Intensive Treatment of Type 2 Diabetes

目的探讨甘精胰岛素联合二甲双胍强化治疗2型糖尿病疗效。方法将93例初诊2型糖尿病患者分为3组:A组38例,采用甘精胰岛素皮下注射,1次.d-1,3餐餐时口服二甲双胍治疗;B组22例,采用人胰岛素R联合中性鱼精蛋白锌胰岛素(NPH)多次皮下注射治疗;C组33例,采用预混人胰岛素30 R早晚各1次皮下注射治疗。比较3组患者血糖达标率、日内平均血糖、日内血糖波动幅度及低血糖发生率。结果B组血糖达标率高于A组与C组,差异有统计学意义(P<0.05);日内平均血糖及日内血糖波动幅度3组比较差异均无统计学意义(均P>0.05);低血糖发生率A组低于B组及C组,差异有统计学意义(P<0.05或P<0.01)。结论3种治疗方式若均能使血糖控制达标情况下,A组与C组治疗血糖控制达标率相当,B组高于A组及C组,但A组低血糖事件发生最低,患者依从性好,治疗更具有效性和安全性。

Objective Studies on efficacy of glargine combining with metformin in the intensive treatment of type 2 diabetes.Methods 93 patients firstly diagnosed with type 2 diabetes were divided into 3 groups.Group A with 38 patients was treated with glargine hypodermicly once daily combining with metformin orally at three meals.Group B with 22 patients was treated with regular insulin combining with NPH.33 patients in group C were hypodermicly injected with premixed insulin 30 R twice daily.Glucose-targeted rate,daily fluctuating range of blood glucose,and incidence rate of hypoglycemia were evaluated in the three groups.Results Glucose-targeted rate in group B was significantly higher than both group A and C（P0.05）.There were no significant differences in daily average blood glucose and fluctuating range of blood glucose between three groups（P0.05）.Incidence rate of hypoglycemia in group A was significantly lower than group B and C（P0.05 or P0.01）.Conclusion In the three groups,glucose-targeted rate in group A was similar with group C,and the one in group B was significantly higher than in both group A and C.Group A,however,had the lowest incidence rate of hypoglycemia when compared with group B and C.It was concluded that the treatment in group A had good compliance,low economic burden,better clinical efficacy and safeness.