长效胰岛素联合瑞格列奈治疗血糖水平控制不佳的2型糖尿病患者的效果

Effect of Long-Acting Insulin Combined with Repaglinide in the Treatment of Patients with Type 2 Diabetes Mellitus with Poorly Controlled Blood Glucose Level

目的探讨长效胰岛素(甘精胰岛素)联合瑞格列奈治疗血糖控制不佳的2型糖尿病(T2DM)患者的临床效果。方法选取2018年1月至2019年6月南阳市宛城区第一人民医院收治的血糖水平控制不佳的T2DM患者93例作为研究对象,按照随机数表法分为研究组(47例)和对照组(46例)。对照组接受精蛋白生物合成人胰岛素注射液(预混30R)联合瑞格列奈治疗,研究组接受甘精胰岛素联合瑞格列奈治疗。比较两组疗效、治疗前后血糖指标[空腹血糖(FPG)、糖化血红蛋白(HbA1c)、餐后2 h血糖(2 h PG)水平]、低血糖发生率、生存质量。结果研究组总有效率(93.62%)高于对照组(78.26%)(P<0.05)。治疗前两组FPG、HbA1c、2 h PG水平比较,差异无统计学意义(P>0.05);治疗3个月后研究组FPG、HbA1c水平低于对照组(P<0.05)。治疗前两组生理、治疗依从性、心理、社会关系评分比较,差异无统计学意义(P>0.05);治疗3个月后研究组生理、心理评分低于对照组(P<0.05),治疗依从性、社会关系评分降低,但与治疗前比较,差异无统计学意义(P>0.05)。研究组低血糖发生率(2.13%)低于对照组(19.57%)(P<0.05)。结论甘精胰岛素联合瑞格列奈治疗血糖水平控制不佳的T2DM患者效果确切,能有效控制患者血糖水平,降低低血糖发生率。

Objective To investigate the clinical effect of long-acting insulin(insulin glargine)combined with repaglinide in the treatment of patients with type 2 diabetes mellitus(T2DM)with poor glucose control.Methods A total of 93 patients with T2DM who had poor sugar control in the First People’s Hospital of Wancheng District of Nanyang City from January 2018 to June 2019 were selected as the research objects.They were randomly divided into the research group(47 cases)and the control group(46 cases).The control group was treated with fertilized protein biosynthetic human insulin injection combined with repaglinide,and the study group was treated with insulin glargine combined with repaglinide.The curative effect,blood glucose indexe[fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),2-hour postprandial blood glucose(2 h PG)],incidence of hypoglycemia and quality of life were compared between the two groups before and after treatment.Results The total effective rate of the study group(93.62%)was higher than that of the control group(78.26%)(P<0.05).There was no significant difference in the levels of FPG,HbA1c and 2 h PG between the two groups before treatment(P>0.05).After 3 months of treatment,the levels of FPG and HbA1c in the study group were lower than those in the control group(P<0.05).There was no significant difference in the scores of physiology,treatment compliance,psychology and social relationship between the two groups before treatment(P>0.05).After 3 months of treatment,the physiological and psychological scores of the study group were lower than those of the control group(P<0.05),and the scores of treatment compliance and social relations decreased,but there was no significant difference compared with those before treatment(P>0.05).The incidence of hypoglycemia(2.13%)in the study group was lower than that in the control group(19.57%)(P<0.05).Conclusion Insulin glargine combined with repaglinide is effective in the treatment of T2DM patients with poor blood glucose control.It can effectively control the blood glucose level and reduce the incidence of hypoglycemia.