甘精胰岛素联合格列美脲及罗格列酮治疗磺脲类继发性失效的2型糖尿病疗效及β细胞功能变化

The effect of insulin glargine combined with glimepiride and rosiglitazone in the treatment of secondary failure of sulfonylurea in type 2 diabetes and the metergasis of β cell

目的探讨甘精胰岛素联合格列美脲及罗格列酮治疗磺脲类继发性失效的2型糖尿病的疗效及β细胞功能变化情况。方法 60例患者随机分为A组和B组各30例,A组给予甘精胰岛素联合格列美脲及罗格列酮治疗,B组给予诺和灵30R皮下注射。2组均治疗12周。测定治疗前后空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1C)、空腹C肽(FCP)、餐后2hC肽(2hCP)及低血糖的发生率。结果治疗后12周2组FPG、2hPG和HbA1C均明显下降,FCP和2hCP均明显升高,差异有统计学意义(P<0.05),但2组间比较差异无统计学意义(P>0.05)。A组发生低血糖反应2例(6.7%),B组发生6例(20.0%),2组比较差异有统计学意义(P<0.05)。结论甘精胰岛素联合格列美脲及罗格列酮治疗磺脲类继发性失效的2型糖尿病有较好疗效,治疗方式简单、方便,易于掌握,值得临床推广应用。

Objective To explore the effect of insulin glargine combined with glimepiride and rosiglitazone in the treatment of secondary failure of sulfonylurea in type 2 diabetes and the condition of islet β cell metergasis.Methods 60 cases were randomly divided into group A and group B,30 cases of each.The group A was treated with insulin glargine combined with glimepiride and rosiglitazone,while group B was given subcutaneous injection of novolin 30R.Both groups were treated for 12 weeks.Compared the fasting plasma glucose（FPG）,2-hour postprandial plasma glucose（2hPG）,glycosylated hemoglobin（HbA1C）,fasting C-peptide（FCP）,2-hour postprandial C-peptide（2hCP） and incidence of low blood glucose before and after treatment.Results After treatment for 12 weeks,the PFG、2hPG and HbA1c of 2 groups were remarkably decreased,but the FCP and 2hCP of 2 groups were significantly increased,and the differences were statistically significant（P0.05）;But there were no statistical significance between 2 groups（P0.05）.The low blood glucose reaction was noticed in 2 cases（6.7%） in group A but 6 cases（20.0%） in group B,and the differences were statistically significant（P0.05）.Conclusion Treating secondary failure of sulfonylurea in type 2 diabetes with insulin glargine combined with glimepiride and rosiglitazone has good effect,and the method is simple,convenient and easy to master,which is worth clinical popularizing and application.