睡前基础胰岛素联合口服降糖药物在2型糖尿病患者强化治疗后的应用分析

Analysis on application of basal insulin combined with oral hypoglycemic agents before bedtime after intensive therapy in T2DM patients

目的探讨睡前基础胰岛素联合口服降糖药物在2型糖尿病患者强化治疗后的应用效果。方法选取2013年9月至2015年1月收治的2型糖尿病患者106例均行强化治疗,分为对照组与联合组。对照组给予口服降糖药治疗,联合组给予胰岛素联合口服降糖药治疗,对比两组患者FBG、2hPBG、HbA1c、FINS、HOMA-IR等指标水平,观察两组患者血糖达标时间及治疗中胰岛素用量,观察两组患者不良反应及末次随访时缓解情况。结果两组患者治疗前FBG、2hPBG、FINS、HbA1c、HOMAIR、ISI、C-P、FMN指标水平差异无统计学意义(P>0.05);联合组患者治疗后FBG、HbA1c、FINS、C-P、FMN、ISI等指标水平与对照组相比差异有统计学意义(P<0.05);联合组患者血糖达标时间及胰岛素用量与对照组相比差异有统计学意义(P<0.05);联合组患者完全缓解率81.13%,明显高于对照组的60.38%,差异有统计学意义(P<0.05)。两组患者均无不良反应。结论 2型糖尿病患者强化治疗后应用睡前基础胰岛素联合二甲双胍治疗的效果较好,值得临床推广应用。

Objective To explore the application effect of basal insulin combined with oral hypoglycemic agents before bedtime after intensive therapy in patients with type-2 diabetes mellitus（T2DM）. Methods One hundred and six cases of T2DM treated with intensive therapy in our hospital from September 2013 to January 2015 were selected and divided into the control group and combination group. The control group was treated with oral hypoglycemic agents, and the combination group was treated with insu- lin combined with oral hypoglycemic agents. FBG, 2 h PBG, HbAlc, FINS and HOMA-IR levels were compared between the two groups. The blood glucose standard reaching time and insulin dosage during treatment were observed, and the adverse reactions and remission situation at the last follow-up were observed in the two groups. Results There were no statistically significant differences in FBG,2 h PBG,FINS, HbAlc, HOMA-IR,ISI,C-P,FMN indexes before treatment between the two groups （P〉0.05） ,but there were statistically significant differences in those indexes after treatment between the two groups （P〈0.05）. The blood glucose standard reaching time and insulin dosage in the combination group were significantly different from those in the control group （P〈0.05）. The complete remission rate in the combination group was 81.13%,which was significantly higher than 60.38% in the control group, the difference was statistically significant （P〈0.05）. There were no adverse reactions in the two groups. Conclusion Basal insulin combined with metformin before bedtime after intensive therapy in T2DM patients has better effect and is worthy of clinical application.