甘精胰岛素联合瑞格列奈治疗老年2型糖尿病疗效及安全性

Efficacy and safety of glargine insulin combined with repaglinide in the treatment of elderly patients with type 2 diabetes

目的观察甘精胰岛素联合瑞格列奈治疗老年2型糖尿病的疗效及安全性。方法将64例老年2型糖尿病患者随机分为2组。观察组32例,采用甘精胰岛素联合瑞格列奈治疗,甘精胰岛素每晚睡前(22∶00)皮下注射1次,瑞格列奈3次/d随餐服用;对照组32例,采用诺和灵治疗,每日早晚2次餐前30 min皮下注射。治疗过程中进行肝肾功能及血常规等检查,观察不良反应发生情况。治疗过程中严密监测患者空腹血糖、餐后2 h血糖、HbA1c,比较两组患者胰岛素用量、低血糖反应发生情况。结果治疗后,两组患者治疗后空腹血糖、餐后2 h血糖、HbA1c均降低(P<0.05),两组比较差异无统计学意义(P>0.05);观察组胰岛素用量、低血糖发生率均低于对照组(P<0.05)。两组患者治疗期间肝肾功能无明显异常,观察组患者2例发生心前区疼痛,对照组5例发生心前区疼痛或心悸。两组不良反应发生率比较差异无统计学意义。结论甘精胰岛素联合瑞格列奈治疗老年2型糖尿病可使血糖得到良好控制,用药方便,患者依从性好,且不良反应发生少。

Objective To observe the efficacy and safety of glargine insulin combined with repaglinide on elderly patients with type 2 diabetes. Methods 64 elderly patients with type 2 diabetes were randomly divided into two groups. Observation group（ n = 32）was treated with glargine insulin combined with repaglinide（ glargine insulin was injected subcutaneously before sleep （22： 00）, once daily; repaglinide was given three times daily with meals ）, control group was injected with novolin subcutaneously at 30 rain before breakfast and lunch, twice daily. The liver/kidney functions, blood tests and the incidence of adverse reactions were observed;the fasting glucose ,2 h postprandial blood glucose, HbA1c were monitored ; the dosage of insulin, occurrence of low blood sugar reaction were recorded. Results After treatment, The fasting blood glucose, 2 h postprandial blood glucose, HbAlc of the two groups decreased （P 〈 0. 05 ） , there was no significant difference between the two groups（ P 〉 0. 05 ） ;The dosage of insulin, incidence of hypoglycemia of observation group were lower than those of control group（ P 〈 0. 05 ）. No significant change was found in the liver/kidney function during the treatment. There were 2 cases of precordial pain in observation group, and 5 cases of chest pain or palpitations in control group, there was no significant difference in the incidence of adverse reactions between the two groups. Conclusion Glargine insulin combined with repaglinide treatment for elderly patients with type 2 diabetes can control the blood sugar effectively ,it is convenient with good compliance of patient and less adverse reactions.