甘精胰岛素、格列美脲片、阿卡波糖片联合治疗磺脲类药物治疗失效糖尿病疗效分析

Efficacy of Insulin Glargine, Glimepiride Tablets and Acarbose in the Treat-ment of Diabetes Mellitus with Sulfonylureas

目的探讨甘精胰岛素、格列美脲片、阿卡波糖片联合治疗磺脲类药物治疗失效糖尿病的疗效。方法方便选择2016年1—12月该院收治的96例磺脲类药物治疗失效的糖尿病患者作为研究对象,采用随机数字表作为分组原则将其分为对照组与研究组,每组48例。对照组采用甘精胰岛素联合格列美脲片治疗,研究组在此基础上口服阿卡波糖片治疗。观察对比两组治疗前与治疗后血糖水平与胰岛功能指标、每日胰岛素用量、24h血糖达标时间及低血糖的发生率。结果研究组治疗后空腹血糖(6.5±1.5)mmol/L、餐后2 h血糖(6.9±1.2)mmol/L、糖化血红蛋白(9.0±1.5)%、胰岛素抵抗指数(0.2±0.2)均低于对照组(7.0±0.5)mmol/L、(7.9±2.0)mmol/L、(9.9±1.7)%、(0.4±0.2),差异有统计学意义(P<0.05),胰岛β细胞功能指数(3.3±1.3)高于对照组(2.0±0.6),差异有统计学意义(P<0.05)。研究组平均每日胰岛素用量为(22.5±4.4)U/d,低于对照组(29.5±4.5)U/d,差异有统计学意义(P<0.05)。研究组24 h血糖达标时间(19.5±4.0)h,高于对照组(13.2±5.2)h,差异有统计学意义(P<0.05)。研究组低血糖发生率4.16%与对照组2.08%对比差异无统计学意义(P>0.05)。结论甘精胰岛素、格列美脲片、阿卡波糖片联合治疗磺脲类药物治疗失效糖尿病疗效确切,可以有效改善患者的血糖水平,强化胰岛功能,适于临床推广。

Objective This paper tries to investigate the effect of insulin glargine,glimepiride tablets and acarbose tablet combined treatment of sulfonylurea therapy failure in diabetes patients.Methods 96 patients with diabetes mellitus treated with sulfonylurea in this hospital from January to December 2016 were convenient selected and randomly divided into control group and study group with 48 cases in each group.The control group were treated with insulin glargine combined glimepiride tablets treatment,research group on the basis of oral treatment of acarbose tablet.The levels of blood glucose and islet function,daily insulin dosage,the time of 24 h blood glucose and the incidence of hypoglycemia before and after treatment were observed and compared between the two groups.Results The fasting blood glucose(6.5±1.5)mmol/L,postprandial blood glucose(6.9±1.2)mmol/L,glycosylated hemoglobin(9.0±1.5)%and insulin resistance index(0.2±0.2)were lower in the study group than those in the control group(7.0±0.5)mmol/L,(7.9±2.0)mmol/L,(9.9±1.7)%,(0.4±0.2),difference are statistically significant(P<0.05).The beta cell function index(3.3±1.3)was higher than that of the control group(2.0±0.6)(P<0.05).The study group average daily insulin dosage(22.5±4.4)U/d,lower than the control group(29.5±4.5)U/d,difference are statistically significant(P<0.05).The study group 24 h blood glucose compliance time(19.5±4.0)h,higher than the control group(13.2±5.2)h,difference are statistically significant(P<0.05).The incidence of hypoglycemia in the study group was 4.16%and 2.08%in the control group,respectively,with no significant difference(P>0.05).Conclusion Glargine,glimepiride tablets,acarbose combination treatment of sulfonylureas in the treatment of failure of diabetes is effective,can effectively improve the patient's blood glucose levels,strengthen the islet function,suitable for clinical promotion.