初诊2型糖尿病单纯药物与联合基础胰岛素治疗对血糖控制及微炎症状态的影响

Comparison of influence of oral antidiabetic drug and combined with basal insulin treatment on diabetic control and micro-inflammatory state in type 2 diabetes mellitus patients

目的：研究2型糖尿病单纯药物与联合基础胰岛素治疗对血糖控制及微炎症状态的影响。方法：2014年5月～2015年6月期间收集重庆市第六人民医院确诊的2型糖尿病128例,采用随机数字法随机分为观察组与对照组2组,观察组予二甲双胍（格华止,0.25g,3次/d）联合基础胰岛素（甘精胰岛素）治疗,对照组予二甲双胍（格华止,0.25g,3次/d起始,最大总剂量2g,必要时加用非胰岛素增敏剂降糖药物）,调整剂量控制血糖达标,疗程6个月。比较2组治疗前后的血糖控制情况、胰岛功能及微炎症指标。结果：观察组、对照组治疗后FPG、HbA1c分别相比较差异具有统计学意义（均P〈0.05）。观察组予联合基础胰岛素治疗后与对照组治疗后AUCc-p、HOMA-β、HOMA-IR差异具有统计学意义（均P〈0.05）。观察组予联合基础胰岛素治疗后与对照组治疗后hs-CRP、IGF-1、IL-6、TNF-α差异均具有统计学意义（均P〈0.05）。结论：2型糖尿病合二甲双胍联合基础胰岛素治疗不仅能够控制血糖,且血糖平稳,微炎症状态指标也有明显降低。

Objective：To investigate the influence of oral antidiabetic drug and combined with basal insulin treatment on diabetic control and micro-inflammatory state in type 2diabetes mellitus patients.Methods：From May 2014 to June 2015,128 cases of Type 2diabetes mellitus were recruited and divided randomly into two groups as observation group and control group.The observation group was given metformin（Glucophage,0.25tid）plus basal insulin（glargine）treatment,while the control group was given metformin（Glucophage,initial dose of 0.25tid;the largest total dose of 2g）plus other non-euglycemic OADs necessarily for 6months to adjust dose and control blood glucose at target.The diabetic control indexes,islet function and micro-inflammatory factors were detected and analyzed.Results：After 6 months of medication,the observation group showed significantly lower level of FPG and HbA1 cthan the control group（P〈0.05）.While AUCc-p,HOMA-βand HOMAIR of the observation group showed significant difference compared to that of the control group after treatment（P〈0.05）.Also the micro-inflammatory indexes including hs-CRP,IGF-1,IL-6and TNF-αof the observation group after treatment were significantly lower than the control group（P〈0.05）.Conclusions：Type 2diabetes given metformin plus glargine not only could control and steady blood glucose,but also significant decrease the micro-inflammation state.