胰岛素治疗联合二甲双胍治疗2型糖尿病的临床探讨

Clinical Study of Insulin Combined with Metformin in the Treatment of Type 2 Diabetes Mellitus

目的讨论胰岛素联合二甲双胍治疗2型糖尿病的临床运用价值。方法将我院120例2型糖尿病患者随机分为观察组和对照组各60例。对照组采用胰岛素治疗,观察组在胰岛素治疗的基础上,加用二甲双胍。记录两组患者治疗前后的空腹血糖、餐后两小时血糖、糖化血红蛋白、体重、每日胰岛素使用量以及血糖达标时间,以评价胰岛素联合二甲双胍治疗2型糖尿病的效果。结果经过治疗后,观察组和对照组的空腹血糖、餐后2小时血糖、糖化血红蛋白较之治疗前明显改善(P<0.05)。但观察组的体重增长只有(1.9±0.4)kg,低于对照组的(4.5±1.2)kg。观察组每日胰岛素使用量为(42±8)U,对照组为(57±11)U,明显低于对照组,P<0.05。观察组血糖达标时间为(8.5±0.3)d,与对照组的(12.4±0.4)d相比,有统计学差异,P<0.05。结论使用胰岛素联合二甲双胍治疗2型糖尿病,可以有效改善患者的餐后2 h血糖和糖化血红蛋白,减少每日胰岛素使用量,缩短血糖达标时间,并避免体重的过快增长,值得临床运用。

Objective To discuss the clinical value of insulin combined with metformin in the treatment of type 2 diabetes mellitus. Methods One hundred and twenty patients with type 2 diabetes mellitus in our hospital were randomly divided into two groups, with 60 cases in each group. Patients in the control group were treated with insulin, while patients in the observation group were treated with insulin combined with metformin. The fasting glucose, two-hour postprandial blood glucose, glycosylated hemoglobin, body weight, daily insulin usage and the time to standard blood glucose before and after treatment were recorded to evaluate the clinical effect. Results After treatment, the fasting glucose, two-hour postprandial blood glucose, glycosylated hemoglobin of both groups improved compared with those before treatment （P〈0.05）. The increase body weight was （1.9 ±_ 0.4） kg in the observation group, significantly lower than （4.5 _± 1.2） kg of control group. The daily insulin usage was （42 _± 8） U of observation group, significantly lower than （57 _± 11） U of control group （P 〈0.05）. The time to standard blood glucose was （8.5 ± 0.3） d in the observation group, significantly lower than （12.4± 0.4） d of control group （P 〈0.05）. Conclusions The use of insulin combined with metformin in the treatment of type 2 diabetes mellitus can effectively improve patient＇s two-hour postprandial blood glucose, reduce the daily insulin usage, shorten the time to standard blood glucose and avoid excessive growth of body weight, which is worthy of clinical application.