格列美脲改善胰岛素敏感性临床疗效研究

Clinical Effectiveness of Glimepiride in Improving Insulin Sensitivity

目的观察应用胰岛素治疗而血糖控制不佳的2型糖尿病患者在加用格列美脲治疗后血糖水平及胰岛素用量的变化,探讨格列美脲增加胰岛素敏感性在临床治疗中的实际意义。方法选取应用胰岛素治疗且血糖控制不佳的2型糖尿病患者56例,随机分为对照组(26例)和观察组(30例)。对照组患者在原治疗方案基础上增加胰岛素剂量,而观察组患者则在原治疗方案基础上加用格列美脲治疗。共观察8周。比较两组患者治疗前后的体质指数(BMI)、血糖〔空腹血糖(FBG)、餐后2 h血糖(2 hPG)〕水平、糖化血红蛋白(HbA1c)水平、胰岛素用量及治疗中的低血糖发生率。结果治疗8周后,观察组患者的BMI、FBG、2 hPG、HbA1c、胰岛素用量及低血糖发生率均低于对照组,差异有统计学意义(P<0.05)。结论应用胰岛素治疗而血糖控制不佳的2型糖尿病患者,加用格列美脲可有效降低FBG、2 hPG、HbA1c水平,减少胰岛素用量,且低血糖发生率低,有利于患者实现HbA1c达标。

Objective To observe the role of glimepiride in improving insulin sensitivity in poorly controlled type 2 di- abetes mellitus （T2DM） patients. Methods Totally 56 patients with poorly controlled T2DM were enrolled in this study and randomly divided into control group （26 cases） and the observation group （30 cases）. The control group received increased insulin in addition to baseline insulin dosage, and the observation group was treated with glimepiride in addition to the conventional treatment plan. Body mass index （BMI） , blood glucose [ fasting blood glucose （FBG） and glucose postprandial （2 hPG）3, glycated hemoglobin （ HbA1c ） , insulin dosage, treatment and incidence of hypoglycemia were recorded and compared. Results Eight weeks after treatment, the observasion group had significantly lower BMI, FBG and 2 hPG, HbA1c, insulin dosage, and incidence of hypoglycemia than in the control group （ P 〈 0. 05 ）. Conclusion Glimepiride can effectively reduce of FBG, 2 hPG and HbA1c levels, reduce the dosage of insulin, hypoglycemia is low, help patients achieve HbA1c compliance, and thus increase the insulin sensitivity in patients with poorly controlled T2DM.