格列美脲治疗传统磺脲类药物继发性失效2型糖尿病患者的临床效果观察

Clinical effect observation of Glimepiride in the treatment of type 2 diabetes patients with secondary failure of traditional Sulfonylureas

目的观察格列美脲治疗传统磺脲药物继发性失效2型糖尿病患者的临床效果。方法选取2015年3月～2017年9月在我院就诊的采用传统磺脲类药物治疗继发性失效的2型糖尿病患者70例作为研究对象,按照随机数字表法将其分为研究组(35例)与对照组(35例)。在停用原先的传统磺脲类药物2周后,研究组患者给予格列美脲治疗,对照组患者给予瑞格列奈治疗,治疗24周。观察两组患者治疗前后空腹血糖、餐后2 h血糖、空腹胰岛素、糖化血红蛋白、体质指数、胰岛素抵抗、胰岛功能指标的变化及不良反应发生情况。结果两组患者治疗后的空腹血糖、餐后2 h血糖、糖化血红蛋白及胰岛素抵抗指标低于治疗前,空腹胰岛素高于治疗前,差异有统计学意义(P<0.05)。两组患者治疗前后的胰岛β细胞功能指标及BMI比较,差异无统计学意义(P>0.05)。研究组患者的空腹血糖、糖化血红蛋白及胰岛素抵抗指数低于对照组,差异有统计学意义(P<0.05)。两组患者均未发生严重的不良反应。结论对传统磺脲药物治疗继发性失效2型糖尿病患者改用格列美脲治疗,其血糖,胰岛素抵抗可以进一步显著改善,且不会增加不良反应,格列美脲可作为治疗磺脲类药物继发性失效2型糖尿病患者的有效方案。

Objective To observe the clinical effect of application of Glimepiride in the treatment of Type 2 diabetes patients with secondary failure of traditional Sulfonylureas. Methods Altogether 70 type 2 diabetes patients with sec- ondary failure who were treated with traditional Sulfonylureas in our hospital from March 2015 to September 2017 were involved as the subjects of this research, and they were divided into study group （35 cases） and control group （35 cas- es）. After 2-week discontinuation of the original Sulfonylureas, patients in study group were given Glimepiride and the patients in control group were treated with Repaglinide, patients were treated for 24 weeks. Changes in fasting blood glucose, 2 h postprandial blood glucose, fasting insulin, glyeosylated hemoglobin, body mass index （BMI）, insulin resis- tance, islet function and adverse reactions were observed before and after treatment in the two groups. Results The fasting blood glucose, 2 h postprandial blood glucose, glyeated hemoglobin and insulin resistance of two groups after treatment were lower than those before treatment, while the fasting insulin of two groups was higher than before treat- ment, with statistically significant differences （P〈0.05）. There were no statistically significant difference in islet [β-cell func- tion and BMI between the two groups before and after treatment （P〉0.05）. The fasting blood glucose, glyeated hemoglobin and insulin resistance of study group were lower than those of the control group, with statistically significant differences （P〈0.05）. There were no serious adverse reactions in the two groups. Conclusion Application of Glimepiride in the treatment of patients with secondary failure of type 2 diabetes who previously underwent traditional Sulfonylurea treat- ment, can further improve patients＇ blood glucose and insulin resistance without increase of adverse reactions. Glimepiride can be used as an effective scheme in the treatment of Type 2 diabetes patients with secondary.