甘精胰岛素、格列美脲、吡格列酮三药联合治疗初诊2型糖尿病的疗效及安全性评价  

Evaluation of curative effect and safety by insulin glargine, glimepiride and pioglitazone in combined treatment of newly diagnosed type 2 diabetes mellitus

作　　者：夏美娜[1] 陈文娟[1] 魏进[1] 韩玉亭[1] 高明殿[1] 

机构地区：[1]山东昌邑市人民医院保健内分泌科,261300

出　　处：《中国实用医药》2017年第1期25-27,共3页China Practical Medicine

基　　金：基金项目:山东省保健科技协会2016年立项科研第29号

摘　　要：目的探讨甘精胰岛素、格列美脲、吡格列酮三药联合治疗初诊2型糖尿病(T2DM)的临床疗效和安全性。方法 120例初诊2型糖尿病患者,随机分为A组(甘精胰岛素联合格列美脲治疗)、B组(甘精胰岛素联合吡格列酮治疗)和C组(甘精胰岛素、格列美脲、吡格列酮三药联合治疗),每组40例。分别给予短期强化治疗12周。比较治疗前后三组患者的空腹(FPG)、餐后2 h血糖(2 hPG)、空腹C肽(FC-P)及餐后2 hC肽(2 hC-P)、糖化血红蛋白(HbA1c)、体质量指数(BMI)、胰岛素抵抗指数(HOMA-IR)、空腹血糖达标时间、胰岛素日用量以及低血糖发生率。结果与治疗前比较,治疗后三组患者FPG、2 hPG、HbA1c及HOMA-IR均显著下降,FC-P、2 hC-P均显著升高,差异具有统计学意义(P<0.05)。三组患者BMI治疗前后比较差异无统计学意义(P>0.05)。治疗后三组FPG、2hPG、HbA1c、HOMA-IR、FC-P、2h C-P及BMI比较差异无统计学意义(P>0.05)。C组低血糖发生率为2.5%,低于A组的15.0%、B组的17.5%,差异具有统计学意义(P<0.05)。C组空腹血糖达标时间短于A、B组,胰岛素用量少于A、B组,差异具有统计学意义(P<0.05)。结论甘精胰岛素联合格列美脲和吡格列酮能很好的控制初诊2型糖尿病患者的血糖,降低胰岛素抵抗,低血糖发生率低,值得临床推广。Objective To investigate clinical effect and safety by insulin glargine, glimepiride and pioglitazone in combined treatment of newly diagnosed type 2 diabetes mellitus（T2DM）. Methods A total of 120 patients with newly diagnosed type 2 diabetes mellitus were randomly divided into group A（insulin glargine combined with glimepiride for treatment）, group B（insulin glargine combined with pioglitazone for treamtent） and group C（insulin glargine combined with glimepiride and pioglitazone for treatment）, with 40 cases in each group. Their short-term intensive treatment all lasted for 12 weeks. Comparison was made on fasting plasma glucose（FPG）, 2 h postprandial blood glucose（2 hPG）, fasting C-peptide（FC-P）, 2 h postprandial C-peptide（2 hC-P）, glycosylated hemoglobin（HbA1c）, body mass index（BMI）, homeostasis model assessment-insulin resistance index（HOMA-IR）, fasting plasma glucose standard time, daily dosage of insulin and incidence of hypoglycemia across the three groups before and after treatment. Results Comparing with those before treatment, all three groups had obviously lower FPG, 2 h PG, HbA1 c, HOMA-IR and higher FC-P and 2 hC-P after treatment, and their difference had statistical significance（P〈0.05）. There was no statistically significant difference of BMI before and after treatment across the three groups（P〉0.05）. After treatment, the difference of FPG, 2 h PG, Hb A1 c, HOMA-IR FC-P, 2 hC-P and BMI had no statistical significance in the three groups（P〉0.05）. Group C had lower incidence of hypoglycemia as 2.5% than 15.0% in group A and 17.5% in group B, and their difference had statistical significance（P〈0.05）. Group C had shorter fasting plasma glucose standard time and less daily dosage of insulin than groups A and B, and their difference had statistical significance（P〈0.05）. Conclusion Combination of insulin glargine, glimepiride and pioglitazone provides good blood glucose control in newly diagnosed type 2 diabetes mellitus patients,

关 键 词：初诊2型糖尿病 甘精胰岛素 格列美脲 吡格列酮 

分 类 号：R587.1[医药卫生—内分泌]