罗格列酮联合胰岛素治疗老年2型糖尿病的临床观察

Clinical Observation of Efficacy of Rosiglitazone Combined with Insulin in Treatment of Elderly Type 2 Diabetes Mellitus

目的 探讨罗格列酮 (RSG)联合胰岛素 (INS)治疗单用INS血糖控制不佳的老年 2型糖尿病 (DM)患者的临床疗效及安全性。方法 将 68例单用INS疗效不佳的老年 2型DM患者随机分为两组各 3 4例 :对照组继续使用合适剂量的胰岛素治疗 ;治疗组在原剂量胰岛素的基础上加服RSG 4mg/d共 2 0周。观察治疗后 4周及 2 0周患者的空腹血糖 (FBG)、餐后 2h血糖 (PBG)、糖化血红蛋白 (HbA1c)、2 4h尿白蛋白排泄率 (UAER)、每日INS用量变化及药物的不良反应等。结果 治疗组 4周后FBG、PBG下降 (P均 <0 0 5 ) ,治疗 2 0周后以上指标下降更显著 ,并使HbA1C、UAER、舒张压、TG及平均每日INS用量下降 ,差异具显著性 (P均 <0 0 5 ) ;对照组治疗后血糖及HbA1c也有一定下降 ,但INS需要量及低血糖发生率明显增加。结论 RSG确实能有效改善老年 2型DM患者的血糖控制 ,治疗安全有效。该药还能改善代谢综合征的一些异常 。

Objective To study the clinical efficacy and safety of Rosiglitazone (RSG) combined with insulin in treatment of elderly type 2 diabetes mellitus (type 2 DM) that had poor response to insulin treatment. Methods 68 cases of elderly type 2 DM patients with poor response to insulin treatment were randomly divided into experimental group and control group.The control group was treated with proper dose of insulin,and the experimental group were administered RSG 4mg/day plus insulin for 20 weeks. 4 weeks and 20 weeks after treatment FBC, PBC, HbA1C, UAER of 24 hrs, daily changes of insulin dosage and side-effect of the medicine were observed. Results In the experimental group the levels of FBG and PBG decreased in 4 weeks(P<0 05),and further decreased in 20 weeks. The levels of HbAIC, UAER, DBP, TG and daily insulin dosage also decreased in 20 weeks in the experimental group. All the indices showed significant differences between the two groups(P<0 05). Conclusions RSG can improve and control the BG level of the elderly type 2 DM patients and has a better tolerance. RSG also has effect on metabolic syndrome and can reduce the incidence of cardiovascular complications of DM.