甘精胰岛素或中效胰岛素联合二甲双胍治疗2型糖尿病患者的比较  

Comparison on Efficacy and Safety of Two Regimens for Treatment of Type 2 Diabetes Mellitus:Glargine plus Metformin versus Neutral Protamine Hagedorn plus Metformin

作　　者：胡茂清[1,2] 罗玉[1,2] 张林[1,2] 杨雪[1,2] 张洪茂[1,2] 

机构地区：[1]成都中医药大学第三附属医院 [2]四川省糖尿病防治中心,成都610041

出　　处：《生物医学工程学杂志》2010年第3期622-625,共4页Journal of Biomedical Engineering

摘　　要：了解甘精胰岛素或中效胰岛素联合二甲双胍治疗对口服降糖药血糖控制不佳的2型糖尿病患者的疗效和安全性。符合纳入标准的60例2型糖尿病患者分成A、B两组,每组各30例。A组用甘精胰岛素联合二甲双胍治疗,B组用中效胰岛素联合二甲双胍治疗,共12周。治疗前后分别测空腹血糖(FPG)、餐后2h血糖(PPG)以及糖化血红蛋白(HbA1c)水平,了解治疗期间两组低血糖的发生情况。两组治疗后较治疗前的FPG、PPG和HbA1c水平降低,差异有统计学意义(P<0.05)。两组治疗后HbA1c水平<7.0%的百分率分别为53.3%和40.0%,差异无统计学意义(P>0.05),两组治疗前HbA1c水平≥7%～<9%的患者,治疗后HbA1c<7.0%的百分率分别为70.6%和62.5%,差异无统计学意义(P>0.05)。两组的轻微低血糖发生率相似(P>0.05)。甘精胰岛素或中效胰岛素联合二甲双胍治疗对口服降糖药控制不佳的2型糖尿病患者可以进一步降低血糖和糖化血红蛋白水平,低血糖发生率低。甘精胰岛素或中效胰岛素联合二甲双胍治疗是口服降糖药控制不佳的2型糖尿病患者安全有效的治疗方案,而中效胰岛素作为基础胰岛素治疗更是廉价而有效的选择。This is a work aimed to investigate the efficacy and safety of the combination of metformin with glargine or with neutral protamine Hagedorn in treatment of type 2 diabetes mellitus. Sixty such patients with poor glycemic control by oral antidiabetic drugs were included and divided into group A and group B. Thirty patients in group A were treated with glargine and metformin,and the other 30 patients in group B were treated with neutral protamine Hagedorn and metformin for 12 weeks. Fasting plasma glucose （FPG）,postprandial glucose（PPG） and HbA1c were measured before and after the treatment. Hypoglycemia was also noted. At the end of the study,the levels of FPG,PPG and HbA1c were significantly lower than the baseline levels in the two groups（P0.05）. At the 12th week,the percentage of HbA1c7% in group A was 53.3% and that in group B was 40.0%; statistically,there was no significant difference （P0.05）. After the end of the treatment,there was no significant difference in that the percentage of HbA1c 7% was 70.6% in group A and 62.5% in group B;the two groups＇ HbA1c levels were ≥7%～9% at the baseline（P0.05）. No sigificant difference in respect to the incidence rate of hypoglycemia in the two groups was noted（P0.05）. In the cases of type 2 diabetes mellitus with poor glycaemic control by oral antidiabetic drug,glucose and HbA1c can be lowered further by the combination of metformin with glargine or with neutral protamine Hagedorn,the incidence rate of hypoglycemia is low. Metformin plus glargine or plus neutral protamine Hagedorn is a safe and effective therapeutic choice for type 2 diabetes mellitus cases with poor glycaemic control; moreover,metformin plus neutral protamine is a cheaper and effective choice.

关 键 词：2型糖尿病 甘精胰岛素 中效胰岛素 二甲双胍 血糖控制 安全性 

分 类 号：R587.1[医药卫生—内分泌]