·糖尿病的胰岛素治疗·

　　作者单位：430022武汉，华中科技大学附属协和医院内分泌科

　　地特胰岛素联合瑞格列奈治疗新诊断2型糖尿病患者疗效及安全性的观察

　　袁莉 黎慧清 汪英 邓秀玲 黎美娟

　　【摘要】目的 观察地特胰岛素联合瑞格列奈在治疗新诊断T2DM患者中的疗效及安全性。方法选择HbA1c≥8.5%的新诊断T2DM患者56例，给予地特胰岛素联合瑞格列奈治疗12周，比较治疗前后FPG、2 hPG、HbA1c、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)、血脂、体重及低血糖发生情况。结果治疗后，FPG、2 hPG、HbA1c、TG、LDL-C及HOMA-IR显著降低(P<0.05);HOMA-β显著增高(P<0.01);体重无明显差异。治疗中低血糖发生率低，无严重低血糖事件发生。结论地特胰岛素联合瑞格列奈治疗可明显改善新诊断T2DM患者糖脂毒性，逆转受损的β细胞功能，且安全性好。

　　【关键词】地特胰岛素;瑞格列奈;糖尿病, 2型;疗效;安全性

　　doi:10.3969/j.issn.1006-6187.2012.05.009

　　Efficacy and safety of insulin determir combined with repaglinide in the treatment of newly diagnosed type 2 diabetic patientsYUAN Li, LI Hui-qing, WANG Ying, et al. Department of Endocrinology, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China

　　【Abstract】ObjectiveTo observe the efficacy and safety of insulin determir combined with repaglinide in the treatment of the newly diagnosed type 2 diabetic patients.MethodsThe 56 newly diagnosed type 2 diabetics with HbA1c≥8.5% were given insulin determir combined with repaglinide for 12 weeks. A comparison on FPG, 2 hPG, HbA1c, HOMA-IR,HOMA-β, blood lipid，islet β-cell function, body weight, and the frequency of hypoglycemia were performed before and after the treatment.ResultsAfter treatment, the FPG, 2 hPG, HbA1c, TG, LDL-C, and HOMA-IR were significantly decreased (all P<0.05), while the HOMA-β was increased (P<0.01). There was no significant difference in the body weight. The incidence of hypoglycemia was low, and there were no serious hypoglycemic events during treatment.ConclusionInsulin determir combined with repaglinide can improve significantly glucolipid toxicity in the newly diagnosed type 2 diabetic patients with a good safety in reversing the damaged function of β cells.

　　【Key words】Insulin determir; Repaglinide; Diabetes mellitus, type 2; Therapeutic effect; Safety