甘精胰岛素联合口服降糖药治疗初诊2型糖尿病的效果观察  

Effect of Glargine combined with oral hypoglycemic medication in the treatment of newly diagnosed type 2 diabetes

作　　者：汤颖[1] 全会标[1] 高勇义[1] 

机构地区：[1]海南省人民医院内分泌科,海南海口570311

出　　处：《海南医学》2014年第17期2522-2525,共4页Hainan Medical Journal

摘　　要：目的观察甘精胰岛素联合用药治疗初诊2型糖尿病的疗效及安全性。方法将初诊为2型糖尿病的患者118例单用二甲双胍(1.0 g/d)治疗4周后,对血糖控制效果不显著的患者选为观察对象,将102例观察对象随机分为三组,甲组36例应用甘精胰岛素联合二甲双胍治疗,乙组32例应用甘精胰岛素与吡格列酮联合治疗,丙组34例则应用甘精胰岛素与二甲双胍和吡格列酮三药联合治疗,各组治疗随访12周,治疗前后检测FPG、2 hPG、HbA1c,TC、TG、LDL-C、HDL-C指标,观察三组患者的FPG达标时间、甘精胰岛素日用量和不良反应发生情况。结果共观察102例,其中男性53例,女性49例,三组患者的年龄、性别、身高体重指数(BMI)均衡性较好,组间差异均无统计学意义(P>0.05)。三组患者经联合用药治疗后FPG全部达标;2 hPG、HbA1c较治疗前均有明显下降,HbA1c除丙组达标外,甲组和乙组只有部分患者达标,各组间比较差异均有统计学意义(P<0.05)。三组患者的BMI均较治疗前有所增加,但增长幅度不大,组间比较差异均无统计学意义(P>0.05)。甲组FPG达标所需时间为(15.55±2.17)d,乙组为(15.91±2.28)d,丙组为(15.23±1.91)d,各组间两两比较差异均无统计学意义(P>0.05)。甲组的甘精胰岛素日均用量为(14.68±1.28)U,乙组为(15.13±1.49)U,丙组为(14.21±1.19)U,各组间两两比较差异均无统计学意义(P>0.05)。三组患者用药后均未出现过敏反应,无肝肾功能损害;有6例初服二甲双胍者稍感上腹不适,数日后症状自行消失;有5例患者稍有浮肿,经治疗后浮肿消退。结论初诊2型糖尿病患者及早使用甘精胰岛素联合用药治疗能有效控制病情,三药联合效果优于二药联合。Objective To observe the clinical effects and safeties of patients with newly diagnosed type 2 diabetes by combining Glargine with oral medication. Methods The 118 patients newly diagnosed as type 2 diabetes were treated by Metformin （1.0 g/d） for 4 weeks. Those （102） had poorly controlled blood glucose were selected and randomly divided into three groups. Group A （n=36） applied Glargine plus Metformin for treatment, group B （n=32） used. Glargine plus Pioglitazone, and group C （n=34） applied Glargine plus Pioglitazone and Metformin. All three groups were given 12 weeks of follow-up. FPG, 2 hPG, HbA1c, TC, TG, LDL-C, HDL-C were detected before and after treatment. Time of FPG reaching standard, Glargine dosage and the incidence of adverse reactions were observed. Results The 102 patients, including 53 males and 49 females, were observed in three groups, which showed no significant difference in age, gender, and Body Mass Index （BMI） （P〉0.05）. FPG of all patients reached the standard after treatment, and 2 hPG and HbAlc levels were decreased after treatment. HbAlc levels in group C all reached the standard, while those in the group A and group B partly reached the standard, with statistically significant difference between the three groups （P〈0.05）. BMI of the all the patients in the three groups increased slightly, but with no significant difference （P〉0.05）. The time to achieve the target of FPG was （15.55 ± 2.17） d in group A, （15.91 ± 2.28） d in group B and （15.23 ± 1.91） d in group C, showing no significant difference （P〉0.05）. Daily dosage of Glargine was （14.68 ± 1.28） U in group A, （15.13 ± 1.49） U in group B, and （14.21 ± 1.19） U in group C, with no significant difference observed between any two groups （P〉0.05）. Three groups were ob-served no allergic reactions and no liver and kidney dysfunction. Six patients had abdominal discomfort with Metformin, and the symptoms disappeared on their own s few days later. Five patients

关 键 词：甘精胰岛素 联合用药 初诊 2型糖尿病 

分 类 号：R587.1[医药卫生—内分泌]