格列美脲治疗老年2型糖尿病安全性和有效性的临床观察

Clinical evaluation of the safety and efficacy of glimepiride treatment in elderly patients with type 2 diabetes

目的评价格列美脲在老年2型糖尿病治疗中的有效性和安全性。方法选择因发生低血糖事件而收治的老年2型糖尿病患者26例，采用格列美脲进行治疗，治疗有效性指标包括治疗前后空腹和餐后2h血糖、糖化血红蛋白、低血糖事件（血糖〈3．9mmol／L）、肝肾功能、血脂和血尿常规等。结果患者改用格列美脲治疗后其空腹和餐后2h血糖、糖化血红蛋白和安全性指标（体重、心电图、血压、心率、肝肾功能、血脂和血尿常规）与治疗前比较，差异无统计学意义（均P〉0．05）；治疗前低血糖事件发生39人次，治疗后9人次，用药前后比较差异有统计学意义（P〈0．01）。结论格列美脲在老年人降血糖和安全性较好，且低血糖发生事件低，适合老年2型糖尿病患者。

Objective To evaluate the clinical safety and efficacy of glimepiride treatment in elderly patients with type 2 diabetes（TzDM）. Methods A total of 26 elderly patients who had encountered incidents of hypoglycemia were treated with glimepiride. Fasting and postprandial 2 h blood glucose, glycosylated hemoglobin （HbAlc）, hypoglycemia （blood glucose 〈 3.9 mmol/L）, liver and kidney function,blood lipids,routine blood and urine tests were analyzed. Results After switch to glimepiride, patients＇ fasting and postprandial 2h blood glucose, HbAlc and the safety indexes （weight,electrocardiogram,blood pressure, heart rate, liver and kidney function, blood lipids, routine blood and urine tests）had no obvious difference, compared with levels before treatment （P〉 0.05） . There was a marked difference in hypoglycemic events before and after treatment with glimepiride（39 vs. 9 events,P〈0.01）. Conclusions Glimepiride is safe and effective in blood glucose control with low incidents of hypoglycemia and is a good choice for elderly patients with type 2 diabetes.