文达敏治疗2型糖尿病的疗效观察

Effects of Avandamet in Patients with Type 2 Diabetes

目的：观察文达敏治疗2型糖尿病的疗效与安全性。方法选择120例应用较大剂量胰岛素（诺和锐30）血糖及糖化血红蛋白仍控制不佳的2型糖尿病患者，给予文达敏治疗12周，比较治疗前后患者空腹血糖、餐后2小时血糖、空腹胰岛素、餐后2小时胰岛素、糖化血红蛋白、腰围、体重指数（BMI）及全天胰岛素用量指标，并计算胰岛素抵抗（IR）指数（HOMA - IR）、胰岛素敏感指数（ISI）、胰岛β细胞分泌功能指数（HOMA - IS）。结果治疗后患者的糖化血红蛋白、空腹血糖、餐后2小时血糖、空腹胰岛素、餐后2小时胰岛素显著降低（P 〈0.05）；BMI、腰围稍有增加，差异无统计学意义（ P 〉0.05）；HOMA - IR 显著降低，HOMA -IS、ISI 升高（P 〈0.01），并且全天胰岛素用量明显下降（P 〈0.01）。结论文达敏能显著降低2型糖尿病患者的血糖、糖化血红蛋白，并且能减轻 IR，增加胰岛素敏感性，恢复胰岛β细胞功能，减少全天胰岛素的用量。

Objective To observe the efficacy and safety of avandamet in the treatment of Patients with tyPe 2 diabetes. Methods 120 Patients with tyPe 2 diabetes using large dose of insulin（AsPart 30）with bad control of blood sugar and glycosylated hemoglobin were enrolled. Each Patient was treated with avandamet for 12 weeks. Fasting Plas-ma glucose,two - hour PostPrandial Plasma glucose,fasting insulin,two - hour fasting insulin,glycosylated hemoglo-bin,waist,body mass index（BMI）and insulin dosage throughout the day were comPared before and after treatment. HOMA - insulin resistance index（HOMA - IR）,HOMA - insulin sensitive index（ISI）and HOMA - insulin secretion （HOMA - IS）were calculated. Results Glycosylated hemoglobin,fasting Plasma glucose,two - hour PostPrandial Plasma glucose,fasting insulin,two - hour fasting insulin significantly decreased after treatment（P 〈 0. 05）. BMI and waist increased slightly（P 〉 0. 05）. HOMA - IR decreased significantly,and HOMA - IS and ISI increased（P 〈 0. 01）. Insulin dosage throughout the day decreased significantly（P 〈 0. 01）. Conclusions Avandamet can significantly reduce blood glucose and glycosylated hemoglobin. It can also alleviate insulin resistance,increase insulin sensitivity, restore the function of islet β cells,and decrease insulin dosage throughout the day.