西格列汀或瑞格列奈联合甘精胰岛素治疗2型糖尿病的临床观察

Clinical Observation of Sitagliptin plus Glargine Insulin versus Repaglinide plus Glargine Insulin in the Treatment of Type-2 Diabetes

目的比较西格列汀联合甘精胰岛素与瑞格列奈联合甘精胰岛素治疗2型糖尿病(T2DM)的疗效。方法将2011年1月-2012年12月80例服用2种口服降糖药(OAD)血糖控制不佳的T2DM患者,按就诊奇偶顺序分为观察组和对照组各40例,观察组采用西格列汀联合甘精胰岛素予以治疗,对照组应用瑞格列奈联合甘精胰岛素治疗,治疗12周,观察两组患者空腹血糖(FBG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)、体质量指数(BMI)等指标及胰岛素用量、低血糖发生情况。结果治疗后两组FBG、2hPG、HbA1c均较前下降(P<0.05);观察组与对照组HbA1c达标率分别为88.3%、87.8%,但观察组胰岛素用量比对照组减少12.1%,且BMI得到控制,低血糖发生率低。结论西格列汀联合甘精胰岛素治疗可有效控制血糖和体质量,减少低血糖事件,在同等HbA1c达标率下,所用的胰岛素剂量更少。

Objective To compare the efficacy of sitagliptin plus glargine insulin versus repaglinide plus glargine insulin in the treatment of Type-2 diabetes mellitus（T2DM）. Methods A total of 140 T2 DM patients who were inadequately controlled by oral anti-diabetic agents from January 2011 to December 2012 were divided into sitagliptin plus glargine insulin group（observation group） or repaglinide plus glargine insulin group（control group）. The duration of treatment was 12 weeks. Fasting blood glucose（FBG）, 2h plasma glucose（2hPG）, glycated haemoglobin（HbA1c）, body max index（BMI） and dose of insulin as well as hypoglycemia events were recorded and analyzed. Results After treatment, FBG, 2hPG, and HbA1 c were significantly decreased in both groups（P〈0.05）. HbA1 c targeting rate was 88.3% in the observation group and 87.8% in the control group. Compared with the control group, the observation group used 12.1% less dosage of insulin, and had decreased BMI and low incidence of hypoglycemia. Conclusions Sitagliptin plus glargine insulin can effectively control blood glucose and body weight with low incidence of hypoglycemia and much less insulin dosage under the same HbA1 c targeting rate. Sitagliptin plus glargine insulin is a good combination therapy for the treatment of T2 DM.