瑞格列奈联合甘精胰岛素对T2DM患者HbA1c及24Hu-TP水平的影响

Effect of repaglinide combined with insulin glargine on HbA1c and 24Hu-TP levels in patients with type 2 diabetes mellitus

目的探究瑞格列奈联合甘精胰岛素对2型糖尿病(T2DM)患者糖化血红蛋白(HbA1c)及24 h尿蛋白定量(24Hu-TP)水平的影响。方法选取2017年3月至2019年3月核工业四一七医院收治的T2DM患者102例为研究对象,按照随机数表法分为观察组和对照组各51例。对照组在常规治疗基础上行瑞格列奈药物治疗,观察组在对照组的基础上联合甘精胰岛素治疗,两组患者均治疗3个月。比较两组患者的疗效,以及治疗前后的HbA1c水平、HbA1c达标率和24Hu-TP水平。结果观察组患者的治疗总有效率为92.16%,明显高于对照组的76.47%,差异具有统计学意义(P<0.05);治疗1、2、3个月后,观察组患者的HbA1c水平分别为(8.21±1.56)%、(7.15±1.40)%、(6.11±1.32)%,对照组分别为(8.87±1.54)%、(8.05±1.48)%、(7.02±1.45)%,两组治疗后HbA1c的时点、组间、时点与组间的交互差异均有统计学意义(P<0.05);治疗1、2、3个月后,观察组患者的24Hu-TP水平分别为(326.14±13.78) mg、(212.87±11.69) mg、(119.26±10.78) mg,对照组分别为(386.25±13.64) mg、(268.15±12.58) mg、(178.24±10.59) mg,两组治疗后24Hu-TP的时点、组间、时点与组间的交互差异均具有统计学意义(P<0.05);观察组患者治疗后HbA1c<7.0%的达标率为84.31%,略高于对照组的72.55%,但差异无统计学意义(P>0.05)。结论瑞格列奈联合甘精胰岛素可有效改善T2DM患者的HbA1c水平,减少T2DM患者低血糖发生率,且对降低T2DM患者24Hu-TP水平具有积极意义。

Objective To investigate the effect of repaglinide combined with insulin glycine on HbA1c level and 24-hour urinary protein(24 Hu-TP) level in patients with type 2 diabetes mellitus(T2DM). Methods A total of 102 T2DM patients admitted to 417 Hospital of Nuclear Industry from March 2017 to March 2019 were selected as study subjects, which were divided into the observation group and the control group according to the random number table, with 51 patients in each group. The control group was treated with repaglinide on the basis of conventional treatment, and the observation group was treated with insulin glargine on the basis of the control group. Both groups were treated for 3 months. The clinical efficacy, HbA1c level, HbA1c compliance rate, and 24 Hu-TP level of the two groups were compared before and after treatment. Results The total effective rate of the observation group was 92.16%, significantly higher than 76.47% of the control group(P<0.05). After 1, 2, and 3 months of treatment, the HbA1c levels of the observation group were(8.21±1.56)%,(7.15±1.40)%, and(6.11±1.32)%, respectively, while those of the control group were(8.87±1.54)%,(8.05±1.48)%, and(7.02±1.45)%. There were statistically significant differences in HbA1c among different time points, between the two groups, and among interactions between time points and groups(P<0.05). After 1,2, and 3 months of treatment, the 24 Hu-TP levels of the observation group were(326.14±13.78) mg,(212.87±11.69) mg,and(119.26±10.78) mg, respectively, while those of the control group were(386.25±13.64) mg,(268.15±12.58) mg, and(178.24±10.59) mg. There were statistically significant differences in 24 Hu-TP among different time points, between the two groups, and among interactions between time points and groups(P<0.05). The compliance rate of HbA1c<7.0% in the observation group after treatment was 84.31%, slightly higher than 72.55% in the control group, with no significant difference(P>0.05). Conclusion Reglitazone combined with insulin glargine can effectively improve HbA1c blood glucose levels in T2 DM patients, reduce the incidence of hypoglycemia in T2DM patients, and has a positive effect on the reduction of 24 Hu-TP level in T2DM patients.