格列美脲联合甘精胰岛素治疗2型糖尿病

Analysis of 39 Patients with Type 2 Diabetes Treated by Glargine Combined with Glimepiride

目的:比较甘精胰岛素(IG)、中性鱼精蛋白锌胰岛素(NPH)分别与格列美脲联用治疗2型糖尿病患者的疗效。方法:39例口服降糖药而血糖控制不佳[糖化血红蛋白(HbA1C)>7.0%]的2型糖尿病患者睡前注射1次IG;44例口服降糖药而血糖控制不佳(HbA1C>7.0%)的2型糖尿病患者睡前注射1次NPH。两组均联用格列美脲早晨1次口服治疗16周,比较IG组和NPH组治疗前后空腹血糖(FPG)和HbA1C的变化。结果:治疗16周时,IG组和NPH组的HbA1C值分别下降(4.1±0.7)%和(3.3±0.6)%,FPG水平分别下降3.5±1.6mmol.L-1和4.4±1.6mmol.L-1,两组疗效间的差异均无统计学意义(P>0.05)。IG组较NPH组发生低血糖事件次数显著减少(P<0.05)。结论:睡前注射1次IG或NPH联用口服格列美脲的治疗方法可使单纯口服降糖药控制不佳的2型糖尿病患者的血糖得到良好控制。两种方法的疗效大致相同,但IG治疗低血糖事件发生率低,故更具选择优势。

Objective：To study comparison of therapeutic effects between glargine（IG） and isophane in sulin（NPH） combined respectively with glimepiride in type 2 diabetes mellitus.Methods： Thirty-nine patients with type 2 diabetes in plasma glucose poorly controlled（HbA1C 7.0%） with treatment of oral hypoglycemic agents injected IG before sleep and 44 patients with type 2 diabetes in plasma glucose poorly controlled（HbA1C 7.0%） with treatment of oral hypoglycemic agents injected NPH before sleep,combined with treatment of glimepiride in the morning once every day for 16 weeks.The changes of FPG and HbA1C levels before and after the treatment were compared between IG group and NPH group,and differences between the two groups were evaluated.Results： By 16 weeks,the mean value of HbA1C in IG group and NPH group decreased 4.1%±0.7 % and 3.3%±0.6 %（P0.05）,respectively the mean value of FPG decreased respectively 3.5±1.6 mmol·L-1 and 4.4±1.6 mmol·L-1（P0.05）,there were no significant difference at efficacy between the two groups.The numbers of incidence of hypoglycemia at night decreased significantly in IG group compared with NPH group（P0.05）.Conclusions： The present study shows that patients with type 2 diabetes in plasma glucose poorly controlled with treatment of oral hypoglycemic agents can be well controlled by injection of IG or NPH before sleep combined with treatment of glimepiride in the morning every day.The efficacy in two methods of injection with IG or NPH is similar,but treatment of IG is lower in incidence of hypoglycemia thus much selective advantage than NPH.