预混胰岛素联合格列美脲治疗2型糖尿病临床观察  

Clinical observation of premixed insulin with glimepiride therapy for type 2 diabetes

作　　者：辛爽清[1] 米垚川[1] 王笑烨 孙媛媛[1] 

机构地区：[1]辽宁省人民医院,沈阳110016

出　　处：《实用药物与临床》2015年第3期359-361,共3页Practical Pharmacy and Clinical Remedies

摘　　要：目的观察应用较大剂量胰岛素联合非促泌剂治疗血糖仍然控制不佳的2型糖尿病患者增加格列美脲的疗效及对胰岛素使用剂量的影响。方法选择每日胰岛素用量均≥40单位的患者,所选病例在饮食及运动量不变的情况下,随机分为原方案组(胰岛素组)和加用格列美脲组(格列美脲组),胰岛素组根据血糖情况继续增加胰岛素剂量至血糖控制理想,格列美脲组在原治疗方案的基础上加用格列美脲,根据血糖情况调整胰岛素和格列美脲的剂量。比较治疗12周后两组治疗前后空腹血糖、餐后2 h血糖和糖化血红蛋白的变化、胰岛素日剂量、低血糖事件、体重和血脂的变化。结果治疗前后比较,格列美脲组血糖控制明显好于胰岛素组,胰岛素日剂量明显降低,体重低于胰岛素组,两组间低血糖事件比较差异无统计学意义;两组对血脂的影响差异无统计学意义。格列美脲组治疗后各项指标较治疗前也有明显好转。结论胰岛素联合非促泌剂血糖控制不佳的2型糖尿病患者加用格列美脲后胰岛素的日剂量明显降低,在不增加低血糖和患者经济负担基础上持续改善患者的血糖控制,节省外源性胰岛素用量,体重低于单纯胰岛素组。Objective To investigate the efficacy of large doses of insulin combined with non-secretagogues for type 2 diabetes mellitus patients with poorly controlled blood glucose added with glimepiride,and their effects on insulin dosage.Methods Patients with daily dose of insulin more than or equal to 40 units were chose,and randomly divided into original program group（insulin group） and addition of glimepiride group（glimepiride group）.Insulin group still increased the insulin dose according to glycemic until the glycemic was controlled in an ideal level.Glimepiride group increased the dose of insulin and glimepiride according to glycemic.The differences of fasting glucose,2 h postprandial glycemic,HbAlc,insulin daily dose,the number of hypoglycemia,weight and blood lipids of the two groups were compared.Results After treatment,the control of glucose glycemic in glimepiride group was better,daily dose of insulin was less,and the body weight was lower.There was no significant difference in the influence of blood lipids between the two groups.The indicators of glimepiride group were improved significantly after treatment.Conclusion Insulin combined with non-secretagogues for type 2 diabetes mellitus patients with poorly controlled blood glucose added with glimepiride can reduce insulin dose and body weight without increasing the number of hypoglycemia and the economic burden of patients.

关 键 词：格列美脲 预混胰岛素 联合治疗 2型糖尿病 

分 类 号：R587.1[医药卫生—内分泌]