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  

Efficacy and Safety of Three-drug Combination of Insulin Glargine, Glimepiride and Pioglitazone in the Treatment of Newly Diagnosed Type 2 Diabetes

作　　者：李慧玲 LI Huiling(Department of Pharmacy,Second People's Hospital of Panyu District,Guangzhou,Guangdong Province,511431 China)

机构地区：[1]广州市番禺区第二人民医院药剂科,广东广州511431

出　　处：《糖尿病新世界》2021年第11期63-66,70,共5页Diabetes New World Magazine

摘　　要：目的分析甘精胰岛素、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。方法纳入该院于2019年1月—2020年12月间收治的114例初诊2型糖尿病患者作为研究样本,采用随机数表法分为3组,各38例,A组给予甘精胰岛素联合格列美脲治疗,B组给予甘精胰岛素联合吡格列酮治疗,C组给予甘精胰岛素、格列美脲、吡格列酮三药联合治疗,分别给予短期强化治疗12周,评价3组治疗效果。结果3组患者治疗前空腹血糖(FPG)、餐后2 h血糖(2 hPG)、空腹c肽(FC-P)、餐后2 hC肽(2 hC-P)指标值比较差异无统计学意义(P>0.05);治疗后3组FPG、2 hPG指标值明显下降、FC-P、2 hC-P指标值明显提高,差异有统计学意义(P<0.05);治疗后3组FPG、2 hPG、FC-P、2 hC-P指标值比较差异无统计学意义(P>0.05)。3组治疗前糖化血红蛋白(HbAlc)、胰岛素抵抗指数(HOMA-IR)比较差异无统计学意义(P>0.05);3组治疗后HbAlc、HOMA-IR指标值均下降,差异有统计学意义(P<0.05);3组治疗后HbAlc、HOMA-IR指标值比较差异无统计学意义(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。A组低血糖发生率5例(13.16%)、B组低血糖发生率6例(15.79%)、C组38例患者中低血糖发生率1例(2.63%),A组与B组比较差异无统计学意义(χ^(2)=0.279,P=0.597);C组低血糖发生率分别低于A组、B组,差异有统计学意义(χ^(2)=7.624、10.356,P=0.006、0.001)。结论初诊2型糖尿病应用甘精胰岛素、格列美脲、吡格列酮三药联合治疗效果良好,可控制血糖稳定,用药安全。Objective To analyze the efficacy and safety of the combination of insulin glargine,glimepiride,and pioglitazone in the treatment of newly diagnosed type 2 diabetes.Methods A total of 114 newly diagnosed type 2 diabetic patients admitted to the hospital between January 2019 and December 2020 were included as the research samples.They were divided into 3 groups with 38 cases by random number table method.Group A was given insulin glargine combined with glimepiride treatment,group B was given insulin glargine combined with pioglitazone,and group C was given insulin glargine,glimepiride,and pioglitazone.The three groups were given short-term intensive treatment for 12 weeks.The therapeutic effects of the three groups were evaluated.Results The index values of fasting blood glucose(FPG)before treatment,2 h blood glucose after meal(2 hPG),fasting c-peptide(FC-P),and 2 hC peptide(2 hC-P)after meal were no statistically significant difference in the three groups(P>0.05);after treatment,the index values of FPG and 2 hPG in the 3 groups were significantly decreased,and the index values of FC-P and 2 h C-P were significantly increased,and the difference was statistically significant(P<0.05);after treatment,the index values of FPG,2 hPG,FC-P and 2 hC-P in the 3 groups were compared,the difference no statistically significant(P>0.05).The comparison of glycosylated hemoglobin(HbAlc)and insulin resistance index(HOMA-IR)in the three groups before treatment,the difference was no statistically significant difference(P>0.05);the index values of HbAlc and HOMA-IR in the three groups decreased after treatment,and the difference was statistically significant(P<0.05);The index values of HbAlc and HOMA-IR after treatment in the three groups were not statistically significant(P>0.05);the fasting blood glucose of group C was shorter than that of groups A and B,and the amount of insulin was less than that of groups A and B.In the 38 patients in group A,the incidence of hypoglycemia was 5 cases(13.16%),the incidence of hypoglycemia in the

关 键 词：甘精胰岛素 格列美脲 吡格列酮 2型糖尿病 

分 类 号：R587.1[医药卫生—内分泌]