甘精胰岛素联合二甲双胍治疗2型糖尿病的效果

Effect of insulin glargine combined with metformin for type 2 diabetes mellitus

目的观察甘精胰岛素联合二甲双胍治疗2型糖尿病的效果。方法选取2020年1月—2022年10月遵义市播州区人民医院收治的2型糖尿病患者50例,采用随机数字表法分为单药组与联合用药组,各25例。单药组患者采用盐酸二甲双胍片口服,联合用药组患者在单药组基础上联合甘精胰岛素注射液皮下注射,2组患者均连续用药3个月。比较2组临床疗效,用药前及用药3个月后糖脂指标、氧化应激指标、肝肾功能指标及低血糖发生情况。结果联合用药组总有效率为96.00%,高于单药组的68.00%(χ^(2)=4.878,P=0.027)。用药3个月后,2组糖化血红蛋白及空腹血糖、餐后2 h血糖、三酰甘油、总胆固醇、低密度脂蛋白胆固醇水平较用药前下降,高密度脂蛋白胆固醇水平较用药前升高,且联合用药组低/高于单药组(P<0.05或P<0.01);2组活性氧、丙二醛水平较用药前降低,超氧化物歧化酶水平较用药前升高,且联合用药组低/高于单药组(P<0.05或P<0.01)。但2组用药3个月后血尿素氮、丙氨酸氨基转移酶、尿微量清蛋白、血肌酐水平比较,差异无统计学意义(P>0.05)。联合用药组与单药组低血糖发生率比较,差异无统计学意义(4.00%vs.12.00%,χ^(2)=0.272,P=0.602)。结论甘精胰岛素联合二甲双胍治疗2型糖尿病的效果显著,可有效改善患者糖脂代谢,降低低血糖发生率,且不会影响患者肝肾功能,安全性较高。

Objective To analyze the effect of insulin glargine combined with metformin for type 2 diabetes mellitus.Methods Fifty patients with type 2 diabetes mellitus admitted to People′s Hospital of Zunyi City Bo Zhou District from January 2020 to October 2022,and they were divided into the single drug group and the combination drug group by random number table method,25 patients in each group.Patients in the single drug group were received oral metformin hydrochloride tablets,and patients in the combination drug group were given subcutaneous injection of insulin glargine injection,both groups were treated for 3 months.Clinical effect,indexes of glycolipid,oxidative stress and liver and kidney function before and after 3 months of medication,incidence of hypoglycemia were compared between the two groups.Results Total effective rate of the combination drug group was 96.00%,it was higher than 68.00%of the single drug group(χ^(2)=4.878,P=0.027).Compared with those before medication,HbA 1c,and levels of FPG,2 hPG,TG,TC,LDL-C after 3 months of medication in the two groups were lower,HDL-C level was higher,and indexes in the combination drug group were better than those in the single drug group(P<0.05 or P<0.01);Levels of ROS,MDA after 3 months of medication of the two groups were lower,SOD level was higher,and the combination drug group were lower/higher than those of the single drug group(P<0.05 or P<0.01).There was no significant difference of levels of BUN,AST,U-MA or SCr after 3 months of medication between the two groups(P>0.05).And there was no significant difference of incidence of hypoglycemia between the combination drug group and the single drug group(4.00%vs.12.00%,χ^(2)=0.272,P=0.602).Conclusion The combination of insulin glargine and metformin can effectively improve the therapeutic effect for type 2 diabetes mellitus,it can effectively improve glycolipid metabolism of patients,and with less impact on liver and kidney function,and with higher safety.