甘精胰岛素结合格列美脲治疗2型糖尿病对患者血糖水平的影响

Effects of insulin glargine combined with glimepiride on blood glucose levels in patients with type 2 diabetes mellitus

目的分析甘精胰岛素联合格列美脲在2型糖尿病患者中的应用价值及对患者血糖水平的影响。方法100例2型糖尿病患者,随机分为对照组和观察组,每组50例。对照组给予甘精胰岛素治疗,观察组给予甘精胰岛素联合格列美脲治疗。比较两组治疗前后血糖指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)]水平、血脂指标[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]水平、胰岛素抵抗指数与体质量。结果治疗前,两组患者的FPG、2 h PG、HbA1c水平比较差异无统计学意义(P>0.05);治疗后,两组患者的FPG、2 h PG、HbA1c水平均低于本组治疗前,且观察组FPG(6.11±0.35)mmol/L、2 h PG(11.25±2.16)mmol/L、HbA1c(6.35±0.41)%均低于对照组的(7.16±0.56)mmol/L、(13.52±3.41)mmol/L、(7.16±0.68)%,差异具有统计学意义(P<0.05)。治疗前,两组患者的TC、TG、LDL-C、HDL-C水平比较差异无统计学意义(P>0.05);治疗后,两组患者的TC、TG、LDL-C水平均低于本组治疗前,HDL-C水平高于本组治疗前,且观察组TC(3.25±0.75)mmol/L、TG(1.86±0.56)mmol/L、LDL-C(1.95±0.52)mmol/L均低于对照组的(4.53±0.87)、(2.26±0.68)、(2.96±0.85)mmol/L,HDL-C(2.13±0.18)mmol/L高于对照组的(1.23±0.13)mmol/L,差异具有统计学意义(P<0.05)。治疗前,两组患者的胰岛素抵抗指数与体质量比较差异无统计学意义(P>0.05);治疗后,两组患者的胰岛素抵抗指数与体质量均低于本组治疗前,且观察组胰岛素抵抗指数(1.42±0.23)与体质量(78.42±8.52)kg均低于对照组的(1.80±0.35)与(82.41±6.41)kg,差异具有统计学意义(P<0.05)。结论甘精胰岛素联合格列美脲治疗2型糖尿病有着较好的降糖、降脂效果,可有效降低胰岛素抵抗指数、体质量,有助于改善患者的预后。

Objective To analyze the application value of insulin glargine combined with glimepiride in patients with type 2 diabetes mellitus,and its influence on blood glucose levels.Methods A total of 100 patients with type 2 diabetes mellitus were randomly divided into control group and observation group,with 50 cases in each group.The control group was treated with insulin glargine,and the observation group was treated with insulin glargine combined with glimepiride.Both groups were compared in terms of blood glucose indexes[fasting plasma glucose(FPG),2 h postprandial glucose(2 h PG),and glycosylated hemoglobin(HbA1c)],and the blood lipid indexes[total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)]levels,insulin resistance index and body weight before and after treatment.Results Before treatment,there was no statistically significant difference in the levels of FPG,2 h PG and HbA1c between the two groups(P>0.05).After treatment,the levels of FPG,2 h PG and HbA1c in the two groups were lower than those before treatment in this group;the levels of FPG(6.11±0.35)mmol/L,2 h PG(11.25±2.16)mmol/L,HbA1c(6.35±0.41)%in the observation group were lower than(7.16±0.56)mmol/L,(13.52±3.41)mmol/L,(7.16±0.68)%in the control group;all the difference were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in the levels of TC,TG,LDL-C and HDL-C between the two groups(P>0.05).After treatment,the levels of TC,TG and LDL-C in the two groups were lower than those before treatment in this group,and the level of HDL-C was higher than that before treatment in this group;the TC(3.25±0.75)mmol/L,TG(1.86±0.56)mmol/L,and LDL-C(1.95±0.52)mmol/L in the observation group were lower than(4.53±0.87),(2.26±0.68),and(2.96±0.85)mmol/L in the control group,and the HDL-C(2.13±0.18)mmol/L was higher than(1.23±0.13)mmol/L in the control group;all the differences were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in insulin resistance index and body weight between the two groups(P>0.05).After treatment,the insulin resistance index and body weight of the two groups were lower than those of this group before treatment,and the insulin resistance index(1.42±0.23)and body weight(78.42±8.52)kg of the observation group were lower than(1.80±0.35)and(82.41±6.41)kg of the control group.All the differences were statistically significant(P<0.05).Conclusion Insulin glargine combined with glimepiride has good hypoglycemic and lipid-lowering effects,which can effectively improve the levels of blood glucose and lipids,reduce insulin resistance index and body weight,and help improve the prognosis of patients.