甘精胰岛素治疗罗格列酮与二甲双胍降糖不佳的2型糖尿病患者的临床观察

发布时间：2018-08-18 14:46

【摘要】：目的:观察甘精胰岛素治疗罗格列酮与二甲双胍降糖不佳的2型糖尿病患者的效果。方法:选择2013年8月-2015年12月于我院接受治疗的经罗格列酮与二甲双胍降糖不佳的2型糖尿病患者90例,按随机数字表法分为对照组与观察组,各45例。对照组患者给予阿卡波糖片50mg餐前口服,tid,最大剂量为300mg/d;观察组患者给予甘精胰岛素注射液皮下注射,qd,起始剂量为0.15u/kg,以后根据血糖监测结果对剂量进行调整,最大剂量为40u/d。两组患者均治疗24周。比较两组患者治疗前后的空腹血糖、餐后2h血糖、糖化血红蛋白(HbA_1c)、空腹C肽和餐后2hC肽水平,记录患者血糖达标时间和不良事件发生情况,并计算不良事件发生率。结果:治疗前,两组患者的上述指标比较,差异均无统计学意义(P0.05)。治疗后,两组患者的空腹血糖和餐后2h血糖水平均显著低于治疗前,空腹C肽、餐后2hC肽和HbA_1c水平均显著高于治疗前;且除空腹血糖外,观察组患者上述指标均显著优于对照组,差异均有统计学意义(P0.05)。观察组患者血糖达标时间显著短于对照组,夜间低血糖、严重低血糖、水肿、胃肠道反应以及总不良事件的发生率均显著低于对照组,差异均有统计学意义(P0.05)。结论:甘精胰岛素用于治疗罗格列酮与二甲双胍降糖效果不佳的2型糖尿病患者,能有效降低其血糖和HbA_1c水平,改善胰岛功能,且安全性较高。
[Abstract]:Objective:To observe the effect of insulin glargine in the treatment of type 2 diabetes mellitus with inadequate antidiabetic effect of rosiglitazone and metformin.Methods:90 cases of type 2 diabetes mellitus with inadequate antidiabetic effect of rosiglitazone and metformin our hospital from August 2013 to December 2015 were randomly divided into control group and observation group, 45 cases in each group. Patients in the control group were given Acarbose Tablets 50 mg orally before meal, tid, the maximum dose was 300 mg / d; patients in the observation group were given insulin glargine injection subcutaneously, qd, the initial dose was 0.15 U / kg, and then according to the results of blood glucose monitoring to adjust the dose, the maximum dose was 40 U / D. The fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin (HbA_1c), fasting C-peptide and postprandial 2-hour C-peptide levels were recorded, and the occurrence of adverse events was calculated. The levels of fasting C-peptide, 2-hour C-peptide and HbA_1c in the observation group were significantly lower than those in the control group (P 0.05). The blood glucose level in the observation group was significantly shorter than that in the control group, and the levels of fasting C-peptide, 2-hour C-peptide and HbA_1c in the observation group were significantly higher than those in the control group (P 0.05). The incidence of blood glucose, edema, gastrointestinal reactions and total adverse events were significantly lower than those in the control group (P 0.05). Conclusion: Insulin glargine can effectively reduce blood glucose and HbA_1c levels, improve islet function, and is safe in the treatment of type 2 diabetes mellitus with rosiglitazone and metformin. High.
【作者单位】：新乡医学院第一附属医院内分泌一病区;
【分类号】：R587.1

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