2种口服降糖药物联合胰岛素治疗初诊2型糖尿病的临床对比研究

Clinical comparative study of two oral hypoglycemic drugs combined with insulin against firstly diagnosed T2DM

目的:探讨2种口服降糖药物分别联合人工合成胰岛素对初诊2型糖尿病(T2DM)的患者血糖指标、胰岛β细胞功能及低血糖发生率的影响。方法:研究对象选取某院2013年4月-2015年12月收治初诊T2DM患者共120例,以随机数字表法分为A组(60例)和B组(60例),分别在甘精胰岛素应用基础上加用罗格列酮和格列美脲辅助治疗;比较2组患者血糖达标时间,胰岛素用量,治疗前后BMI水平、血糖指标水平、胰岛β细胞功能指标水平、低血糖及心血管疾病发生率等。结果:2组患者血糖达标时间和胰岛素用量比较差异无显著性意义(P>0.05);B组患者治疗后BMI水平显著低于A组(P<0.05);2组患者治疗后血糖和胰岛β细胞指标水平组间比较差异无显著性意义(P>0.05);同时B组患者低血糖发生率显著低于A组(P<0.05);2组患者心血管疾病发生率比较差异无显著性意义(P>0.05)。结论:罗格列酮和格列美脲分别联合人工合成胰岛素治疗初诊T2DM临床疗效接近,但格列美脲口服可有效减少体质量增加量,降低低血糖发生风险,更具临床应用价值。

OBJECTIVE To investigate the effects of two oral hypoglycemic drugs respectively combined with insulin on blood glucose,βcell function and hypoglycemia incidence in patients firstly diagnosed with T2 DM.METHODS A total of 120 patients with T2 DM firstly diagnosed were chosen in from April 2013 to December 2015 in our hospital and randomly divided into two groups,including group A（60 patients）administering pioglitazone and group B（60 patients）administering glimepiride combined with glargine insulin.Recovery time of blood glucose,insulin doses,levels of BMI,blood glucose indexes,βcell function indexes,hypoglycemia and angiocardiopathy were compared before and after treatment between two groups.RESULTS No significant difference was observed in recovery time of blood glucose and insulin doses between2 groups（P〉0.05）.The level of BMI after treatment in group B was significantly lower than that before treatment（P〈0.05）.No significant difference was observed in levels of blood glucose indexes andβcell function indexes between 2 groups（P〈0.05）.The hypoglycemia incidence of group B was significantly lower than that of group A（P〈0.05）.No significant difference was found in the incidence of angiocardiopathy between 2 groups（P〉0.05）.CONCLUSION Pioglitazone and glimepiride respectively combined with insulin have the same clinical effects in patients with T2 DM firstly diagnosed.Glimepiride can efficiently reduce the weight gain and the risk of hypoglycemia.