甘精胰岛素联合口服降糖药治疗2型糖尿病临床效果观察

Clinical effect of insulin glargine combined with oral hypoglycemic agents on type 2 diabetes mellitus

目的观察甘精胰岛素联合口服降糖药治疗2型糖尿病的临床效果。方法选择2017年11月-2019年6月于广州市番禺中心医院接受胰岛素泵强化治疗的血糖控制不佳(HbA1c> 9%)的2型糖尿病患者68例,其中采用甘精胰岛素联合口服降糖药治疗的患者41例为观察组,采用单纯口服降糖药治疗的患者27例为对照组。回顾性分析2组患者临床资料,比较2组治疗前和治疗6个月后血糖、C肽、HbA1c水平,HbA1c控制率。结果治疗6个月后,2组空腹血糖和餐后2 h血糖均显著低于治疗前,空腹C肽、餐后2 h C肽水平均高于治疗前(P<0.01);治疗6个月后,2组血糖、C肽水平比较差异均无统计学意义(P>0.05)。治疗6个月后,2组HbA1c水平均显著低于治疗前(P<0.01),但2组比较差异无统计学意义(P>0.05),2组HbA1c控制率比较差异无统计学意义(P>0.05)。结论短期胰岛素强化治疗2型糖尿病后,采用口服降糖药、甘精胰岛素联合口服降糖药均对长期血糖控制具有良好的治疗效果,但甘精胰岛素联合口服降糖药治疗更有利于初始HbA1c相对较高且高血糖控制不佳患者的长期血糖控制。

Objective To observe the clinical effect of insulin glargine combined with oral hypoglycemic agents in the treatment of type 2 diabetes. Methods A total of 68 type 2 diabetes patients with poor blood glucose control(HbA1c > 9%)who received intensive insulin pump therapy in Guangzhou Panyu Central Hospital,Guangdong province from November 2017 to June 2019 were selected. Among them,41 patients who received insulin glargine combined with oral hypoglycemic agents were selected as the observation group. 27 patients treated with oral hypoglycemic drugs were the control group. The clinical data of the 2 groups were retrospectively analyzed,and the levels of blood glucose,C-peptide,HbA1c and the control rate of HbA1c were compared between the 2 groups before treatment and 6 months after treatment. Results After 6 months of treatment,the fasting blood glucose and the 2 h postprandial blood glucose of the two groups were significantly lower than before treatment,and the fasting C-peptide and 2 h postprandial C-peptide levels were higher than those before treatment(P< 0. 01).6 treatments months later,there were no significant difference in blood glucose and C-peptide levels between the two groups(P > 0. 05). After 6 months of treatment,the levels of HbA1c in the two groups were significantly lower than before treatment(P< 0. 01). But there was no significant difference in HbA1c levels between the two groups(P > 0. 05). There was no significant difference in the control rate of HbA1c between the two groups(P > 0. 05). Conclusion Short-term insulin intensive treatment of type 2 diabetes,the use of oral hypoglycemic drugs or insulin glargine combined with oral hypoglycemic drugs have a good therapeutic effect on long-term blood sugar control,but the treatment of insulin glargine combined with oral hypoglycemic drugs is more conducive to the initial HbA1c. Long-term blood glucose control in patients with high and poorly controlled hyperglycemia.