赖脯胰岛素联合二甲双胍在2型糖尿病短期胰岛素强化治疗后的应用随访  

Follow-up of insulin lispro combined with metformin in patients with type 2 diabetes after short-term insulin intensive treatment

作　　者：倪林[1] 叶蕾[1] 车惠琴[1] 王菲菲[1] NI Lin;YE Lei;CHE Huiqin;WANG Feifei(Department of Endocrinology,Huzhou First People's Hospital in Zhejiang Province,Huzhou313000,China)

机构地区：[1]浙江省湖州市第一人民医院内分泌科,浙江湖州313000

出　　处：《中国现代医生》2020年第25期50-53,57,共5页China Modern Doctor

基　　金：浙江省科技计划项目(2016C33217)。

摘　　要：目的探讨赖脯胰岛素联合二甲双胍应用于2型糖尿病(T2DM)短期胰岛素强化治疗后的价值。方法前瞻性选取湖州市第一人民医院2018年5月~2019年6月收治的初诊T2DM患者133例接受短期胰岛素强化治疗,126例治疗后血糖达标,采用随机数字表法分为对照组(63例)与观察组(63例),对照组采用饮食运动治疗,观察组采用赖脯胰岛素联合二甲双胍治疗,对两组患者维持治疗前、随访1个月、3个月、6个月的血糖控制效果、β细胞功能情况与不良反应发生情况进行比较。结果维持治疗前、1个月后两组患者血糖控制效果数据比较,差异均无统计学意义(P>0.05),3个月后观察组LDL-C、FPG、2 hPG、HbA1c水平低于对照组,差异有统计学意义(P<0.05),6个月后观察组TG、LDL-C、FPG、2 hPG、HbA1c低于对照组,差异有统计学意义(P<0.05);维持治疗前两组患者β细胞功能比较,差异无统计学意义(P>0.05),1个月后观察组HOMA-β水平高于对照组,差异有统计学意义(P<0.05),3个月、6个月后观察组HOMA-IR水平明显低于对照组,HOMA-β水平明显高于对照组,差异有统计学意义(P<0.05);对照组发生低血糖反应3例、皮肤瘙痒2例,观察组发生低血糖反应1例,不良反应发生率比较差异无统计学意义(P>0.05)。结论T2DM患者短期胰岛素强化治疗后采用赖脯胰岛素联合二甲双胍进行维持治疗可有效控制血糖、改善胰岛素敏感、逆转β细胞功能。Objective To explore the value of insulin lispro combined with metformin after short-term intensive insulin therapy for type 2 diabetes(T2 DM).Methods A total of 133 patients with newly diagnosed T2 DM who were admitted to the Huzhou First People’s Hospital from May 2018 to June 2019 were prospectively selected and were ttreated with short-term intensive insulin therapy.126 patients achieved standard blood glucose level after treatment.They were divided into a control group(n=63)and an observation group(n=63).The control group was treated with diet and exercise therapy.The observation group was treated with insulin lispro combined with metformin.The blood glucose control effect,βcell function and adverse reactions between the two groups were compared before maintenance treatment,at 1,3,and 6 months follow-up.Results Before and after 1 month of the maintenance treatment,there was no significant difference in blood glucose control effect between the two groups(P>0.05).After 3 months,the levels of LDL-C,FPG,2 hPG and HbA1 c in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The TG,LDL-C,FPG,2 hPG and HbA1 c in the observation group were lower than those of the control group after 6 months,and the differences were statistically significant(P<0.05).There were no statistically significant differences in the function ofβcells between the two groups before maintenance treatment(P>0.05).The HOMA-βlevel in the observation group was higher than that in the control group after 1 month,and the difference was statistically significant(P<0.05).After 3-months,6-months follow-up,the level of HOMA-IR was significantly lower than that of the control group,and the level of HOMA-βwas significantly higher than that of the control group,and the difference was statistically significant(P<0.05).There were 3 cases of hypoglycemic reaction and 2 cases of skin itching in the control group,and 1 case of hypoglycemia in the observation group.And the difference i

关 键 词：赖脯胰岛素注射液 二甲双胍 2型糖尿病 维持治疗 

分 类 号：R587.1[医药卫生—内分泌]