罗格列酮联合胰岛素泵强化治疗2型糖尿病的临床研究

Clinical study of rosiglitazone combined insulin pump treatment of type 2 diabetes mellitus

目的探讨罗格列酮联合胰岛素泵强化治疗2型糖尿病的疗效。方法将90例2型糖尿病患者随机分为胰岛素泵(CSⅡ)+罗格列酮组、单纯CSⅡ组、多次皮下注射胰岛素(MDI)组,每组30例。比较三组患者治疗前及2周后空腹血糖(FBG)、三餐后2h及睡前血糖(BG)、糖化血红蛋白(Hb A1C)、空腹胰岛素(Fins)、C肽(C-P)、胰岛素抵抗指数(HOMA-IR)及胰岛素敏感指数(ISI),并记录血糖达标时间及每日Ins用量。结果三组治疗后FBG、BG及Hb A1C均显著降低,CSⅡ+罗格列酮组与单纯CSⅡ组Fins、C-P、HOMA-IR降低,ISI升高,且较MDI组FBG、早、午餐后2h BG均明显下降,BG达标时间及Ins用量减少,在改善HOMA-IR、ISI及降低Ins用量上CSⅡ+罗格列酮组差异具有统计学意义(P<0.05)。三组均无肝、肾功能损害发生。结论罗格列酮联合胰岛素泵强化治疗2型糖尿病可有效控制血糖,减少胰岛素用量及缓解胰岛素抵抗。

Objective To study the clinical effect of rosiglitazone combined insulin pump in the treatment of type 2 diabetes mellitus.Methods 90 cases with type 2 diabetes mellitus were randomly divided into continuous subcutaneous insulin infusion（CSII） by insulin pum＋rosiglitazone group,simple CSII group,and multiple subcutaneous insulin（MDI） group,with 30 cases in each group.Of the three groups,to compare the fasting blood glucose（FBG） before treatment and 2 weeks later,the blood glucose（BG） 2h three postprandial and before retiring,glycosylated hemoglobin（HbA1C）,fasting insulin（Fins）,C-peptide（C-P）,insulin resistance index（HOMA-IR）,and insulin sensitivity index（ISI）,to record the time of reaching target of glucose and the daily insulin dosage.Results FBG,BG,and HbA1C were all significantly reduced in the three groups.Fins,C-P and HOMA-IR were reduced,ISI was higher,FBG,BG 2h after breakfast and lunch were all significantly reduced in CSII＋rosiglitazone group and simple CSII group compared with MDI group,while the improvement of HOMA-IR and ISI,the decrease of daily insulin dosage were all more significant in CSII＋rosiglitazone group（P〈0.05）.The liver and renal functional impairment haven＇t occurrence in the three groups.ConclusionRosiglitazone combined insulin pump in the treatment of type 2 diabetes mellitus could effectively control BG,reduce the daily insulin dosage,and relieve the insulin resistance.