格列美脲联合胰岛素治疗2型糖尿病的临床观察

Therapeutic effect of glimepiride combined with insulin on type 2 diabetes

目的评价格列美脲联合胰岛素对2型糖尿病（T2DM）的临床疗效。方法 T2DM患者64例,均为单用胰岛素血糖控制欠佳者,随机分为观察组和对照组,观察组加用格列美脲2~4 mg/d,根据血糖调整胰岛素用量;对照组继续应用胰岛素治疗,并根据血糖加大剂量。12周后观察治疗前后空腹血糖（FBG）、餐后2 h血糖（2 hBG）、糖化血红蛋白（HbA1c）、体重指数（BMI）、每日胰岛素用量变化以及药物不良反应。结果治疗后观察组FBG、2 hBG、HbA1c较对照组明显降低,胰岛素用量减少（P〈0.05）;所有入选者共发生低血糖6例,其中观察组2例,对照组4例。结论 T2DM单用胰岛素血糖控制不佳者,加用格列美脲可显著改善血糖控制,低血糖发生率低,并可减少胰岛素用量。

Objective To observe the therapeutic effect of glimepiride combined with insulin on type 2 diabetes.Methods 64 patients with type 2 diabetes who were given single insulin and their blood glucose was not controlled well were randomly divided into two groups： observation group and control group.The patients in observation group were treated with glimepiride（1～4mg,qd.po） combined with insulin,and the dosage of insulin was adjusted according to patients＇blood glucose levels,however,the patients in control group were treated by single insulin continuously.After 12 weeks,the levels of fasting blood glucose（FBG）,2 hour postprandial blood glucose（2hBG）,glycosylated hemoglobin（HbA1C）,body mass index,insulin dosage and drug adverse reaction were detected and observed.Results The levels of FBG,2hBG,and HbA1C in observation group were significantly lower than those in control group（P0.05）,and dosage of insulin was significantly decreased in observation group（P﹤0.05）.Among all the patients there happened 6 cases of hypoglycaemia,2 cases in observation group and 4 cases in control group.Conclusion Glimepiride combined insulin can improve the glucose control and reduce the incidence of hypoglycaemia in patients with type 2 diabetes administrated only with insulin without effective control of blood glucose,and can reduce the dosage of insulin.