那格列奈联合甘精胰岛素治疗糖尿病肾病的疗效观察

TheraPeutic Effect of Nateglinide Combined with Insulin Glargine for the Treatment of Patients with Diahetic NePhroPathy

目的:探讨那格列奈联合甘精岛素治疗2型糖尿病肾病患者的疗效和安全性。方法:52例糖尿病肾病(Mogensen分期Ⅲ-Ⅳ期)患者,随机分为2组,试验组26例,予那格列奈加甘精胰岛素联合治疗;对照组26例,予每日两次预混胰岛素治疗。疗程均为8w,观察治疗前后两组患者空腹血糖(FBG)、餐后2h血糖(2hBG)、糖化血红蛋白(HbA1c)、尿白蛋白排泄率(UAER)、血尿素氮(BUN)、肌酐(SCr)的变化及低血糖发生率的差异。结果:试验组和对照组经治疗后FBG、2hBG、HbA1c、UAER均明显下降(P<0.01),但两组间比较差异无统计学意义(P>0.05);两组治疗前后BUN、SCr差异无统计学意义(P>0.05)。试验组发生低血糖次数少于对照组(P<0.05)。结论:那格列奈联合甘精胰岛素治疗糖尿病肾病可有效控制血糖,安全性和依从性良好。

Objective:To evaluate the efficacy and safety of nateglinide combined with insulin glargine in patients with diabetic nephroPathy.Methods:52 patients with diabetic nephropathy(by Mogensen's stage:Ⅲ～IV) were randomly divided into two groups.26patients in the trial group were treated by repag1inide combined with insulin glargine injection.The other 26 patients in the control group were treated by premixed insulin injection twice daily.Both groups were under treatment for eight weeks as a course,and the values of fasting blood glucose(FBG) ,2h postprandial blood glucose(2hBG) ,glycosylated hemoglobin(HbAlc) ,urinary albumin excretion rate(UAER) ,blood urea nitrogen(BUN) and serum creatinine(SCr) before and after the treatment were observed.The incidence of hypoglycemia of two groups was observed as well.Results:After treatment,the levels of FBG,2hPG,HbA1c and UAER in two groups all decreased obviously(P <0.01) ,but there was no statistical significance between the two groups(P >0.05) .However,the levels of BUN,SCr had no marked difference after the experiment(P >0.05) .Patients in the trial group had fewer hypoglycemic episodes Than those in the control group(P<0.05) . Conclusion:nateglinide combined with insulin glargine can control the blood glucose effectively in patients with diabetic nephropathy,and has high safety accompanied by a simple and easy way in application.