吡格列酮二甲双胍联合胰岛素治疗单用胰岛素控制不佳的2型糖尿病的效果观察

Effect of pioglitazone and metformin combined with insulin on type 2 diabetes mellitus poorly controlled by insulin therapy alone

目的研究吡格列酮二甲双胍联合胰岛素治疗单用胰岛素控制不佳的2型糖尿病的效果。方法抽取晋城市人民医院2020年1月至2022年9月收治的2型糖尿病患者80例,通过随机列表法分为对照组与研究组,每组40例。研究组采用吡格列酮二甲双胍+胰岛素治疗,对照组实施胰岛素强化治疗,比较两组不良反应发生情况、血糖水平、血脂水平、血糖漂移情况。结果研究组不良反应发生率(7.50%,3/40)低于对照组(25.00%,10/40),P<0.05。用药前,两组血糖指标比较差异未见统计学意义(P>0.05);用药后,研究组空腹血糖、餐后2 h血糖、糖化血红蛋白水平均低于对照组(P均<0.05)。用药前,两组血糖漂移情况比较差异未见统计学意义(P>0.05);用药后,研究组日内平均血糖漂移幅度、日间血糖漂移幅度、平均餐后血糖漂移幅度均低于对照组(P均<0.05)。用药前,两组血脂指标比较差异未见统计学意义(P>0.05);用药后,研究组三酰甘油、总胆固醇、低密度脂蛋白胆固醇水平均低于对照组(P均<0.05)。结论吡格列酮二甲双胍+胰岛素治疗单用胰岛素控制不佳的2型糖尿病的效果更为理想,能够降低血糖及血糖漂移情况,不良反应少,并可改善血脂水平。

Objective To study the therapeutic effect of pioglitazone and metformin combined with insulin on type 2 diabetes mellitus poorly controlled by insulin therapy alone.Methods A total of 80 patients with type 2 diabetes mellitus admitted to Jincheng People Hospital from January 2020 to September 2022 were selected,and they were divided into the control group and the study group by random listing method,with 40 cases in each group.The study group was treated with pioglitazone and metformin combined with insulin therapy,and the control group was treated by intensive insulin treatment.The adverse reactions,blood glucose level,blood lipid level,and blood glucose drift of the two groups were compared.Results The incidence of adverse reactions in the study group(7.50%,3/40)was lower than that in the control group(25.00%,10/40),P<0.05.There was no difference in blood glucose indexes between the two groups before administration(P>0.05).Levels of fasting blood glucose,2-hour postprandial blood glucose and glucosylated hemoglobin in the study group were lower than those in the control group after administration(all P<0.05).There was no significant difference in blood glucose drift between the two groups before administration(P>0.05).The mean 1-day blood glucose drift range,daily blood glucose drift range,and mean postprandial blood glucose drift range in the study group were lower than those in the control group after administration(all P<0.05).There was no significant difference in blood lipid indexes between the two groups before administration(P>0.05).The triglycerides,total cholesterol and low-density lipoprotein cholesterol in the study group were lower than those in the control group after administration(all P<0.05).Conclusions The effect of pioglitazone and metformin combined with insulin,in the treatment of patients with type 2 diabetes mellitus poorly controlled by insulin therapy alone,is more ideal,it can reduce blood glucose and blood glucose drift,reduce adverse reactions,and improve blood lipid.