甘精胰岛素和瑞格列奈在老年糖尿病患者中的应用效果研究

Study on the application effect of insulin glargine and repaglinide in the treatment of elderly patients with diabetes mellitus

目的 探讨临床对老年糖尿病患者实施甘精胰岛素、瑞格列奈治疗的效果。方法 100例老年糖尿病患者,随机分为对照组和观察组,每组50例。对照组实施甘精胰岛素治疗,观察组在对照组基础上加用瑞格列奈治疗。对比两组血糖指标[空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)]、不良反应发生率、应激指标[谷胱甘肽过氧化物酶(GSH-Px)、血清同型半胱氨酸(Hcy)]、胰岛功能指标[胰岛B细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)]。结果 治疗后,观察组患者FBG、2 h PG、HbA1c水平分别为(6.23±1.01)mmol/L、(8.04±2.42)mmol/L、(6.77±1.21)%,均低于对照组的(7.58±1.54)mmol/L、(9.59±2.48)mmol/L、(7.88±1.47)%(P<0.05)。观察组总不良反应发生率为6.00%,对照组为4.00%,比较差异无统计学意义(P>0.05)。治疗后,观察组GSH-Px(142.49±8.94)pg/ml高于对照组的(113.57±8.65)pg/ml, Hcy(7.22±1.53)μmol/L低于对照组的(8.99±1.78)μmol/L(P<0.05)。治疗后,观察组的HOMA-β(7.21±1.11)高于对照组的(4.54±0.92), HOMA-IR(3.54±0.76)低于对照组的(5.39±1.16)(P<0.05)。结论 临床对老年糖尿病患者实施甘精胰岛素、瑞格列奈联合治疗,可显著降低患者的血糖水平,改善应激反应、胰岛功能,安全性高。

Objective To explore the effect of insulin glargine and repaglinide in the treatment of elderly patients with diabetes mellitus.Methods 100 elderly patients with diabetes mellitus were randomly divided into a control group and an observation group,with 50 patients in each group.The control group was treated with insulin glargine,and the observation group was treated with repaglinide.Both groups were compared in terms of blood glucose indicators[fasting blood glucose(FBG),2 h postprandial glucose(2 h PG),glycosylated hemoglobin(HbA1c)],incidence of adverse reactions,stress indicators[glutathione peroxidase(GSH-Px),serum homocysteine(Hcy)],islet function indicators[homeostasis model assessment-β(HOMA-β),homeostasis model assessment-insulin resistance(HOMA-IR)].Results After treatment,the levels of FBG,2 h PG and HbA1c in the observation group were(6.23±1.01)mmol/L,(8.04±2.42)mmol/L and(6.77±1.21)%,which were lower than(7.58±1.54)mmol/L,(9.59±2.48)mmol/L and(7.88±1.47)%in the control group(P<0.05).The total incidence of adverse reactions was 6.00%in the observation group and 4.00%in the control group,with no statistical significance(P>0.05).After treatment,the observation group had higher GSH-Px of(142.49±8.94)pg/ml than(113.57±8.65)pg/ml in the control group,and lower Hcy of(7.22±1.53)μmol/L than(8.99±1.78)μmol/L in the control group(P<0.05).After treatment,the observation group had higher HOMA-βof(7.21±1.11)than(4.54±0.92)in the control group,and lower HOMA-IR of(3.54±0.76)than(5.39±1.16)in the control group(P<0.05).Conclusion For elderly patients diabetes mellitus,insulin glargine combined with repaglinide can help reduce blood glucose level,reduce stress response,improve insulin function and has high safety.