格列美脲联合预混胰岛素治疗2型糖尿病患者临床观察

Clinical Observation of Glimepiride Combined with Premixed Insulin Treatment in Type 2 Diabetic Patients

目的:探讨格列美脲联合预混胰岛素对治疗2型糖尿病的临床效果。方法:选择2012年6月—2014年6月于解放军第463医院内分泌科住院的60例2型糖尿病患者,曾单独使用预混胰岛素治疗,血糖控制不佳,分为对照组和治疗组,每组患者30例。两组患者均给予门冬胰岛素30注射液早晚餐前注射治疗,对照组加用二甲双胍口服,治疗组患者加用格列美脲。两组患者观察12周后,观察两组患者的空腹及餐后血糖、糖化血红蛋白、体重指数、胰岛素用量变化情况。结果:两组患者分别治疗12周后,较治疗前空腹及餐后血糖、糖化血红蛋白、胰岛素用量均明显降低(P<0.05),体重指数无明显变化(P>0.05),格列美脲组血糖及糖化血红蛋白下降、低血糖发生与二甲双胍组类似(P>0.05),胰岛素用量较二甲双胍组明显减少(P<0.05)。结论:在使用预混胰岛素剂量偏大且血糖控制不佳的2型糖尿病患者中,如无法联用二甲双胍,可联合应用格列美脲,其降糖疗效确切,且能减少胰岛素用量,不明显增加患者低血糖及体重指数。

Objective：To investigate the clinical effect of glimepiride combined with premixed insulin for the treatment of type 2 diabetes mellitus. Methods：60 cases of inpatients with T2 DM were selected from June 2012 to June 2014 in Endocrine Department of the PLA 463 rd hospital;they had used only premixed insulin therapy and had poor glycemic control. Patients were divided into treatment group and control group,30 cases in each group of patients. Two groups of patients were given Insulin Aspart 30 Injection before breakfast and dinner. The control group were treated with metformin and the treatment group were given glimepiride by oral. Fasting blood glucose,postprandial blood glucose,glycosylated hemoglobin,body mass index,changes in the amount of insulin of two groups were observed after 12 weeks of observation. Results：Two groups of patients were compared after 12 weeks of treatment. Fasting and postprandial blood glucose,glycated hemoglobin,insulin dosage were significantly decreased（P〈0.05）,body mass index had no significant change（P〈0.05）. The decrease of of blood glucose,glycosylated hemoglobin and hypoglycemia in glimepiride group is similar to that in metformin group（P〈0.05）. The decrease of the dosage of insulin in glimepiride group is obvious to that in metformin group（P〈0.05）. Conclusion：If the dose of premixed insulin is large and blood glucose control is poor in patients with type 2 diabetes,and the patients can＇t take if metformin,glimepiride can be used. The treatment is efficacy,and insulin dosage can be lowered, hypoglycemia and increase of body mass index is not significantly