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2型糖尿病口服降糖药失效后改用胰岛素治疗对血管并发症的影响

来自:中国糖尿病资讯网  编辑:editor|点击数:|2012-09-21

 

  【摘要】 目的 探讨2型糖尿病口服降糖药治疗失效后改用胰岛素治疗对血管并发症发生率的影响和相关危险因素。 方法选取住院及门诊453例,分为治疗组(232例)和对照组(221例)。治疗组:注射胰岛素, 严格控制空腹血糖在6mmol/L左右;控制饮食,每日摄入热卡25kcal/kg;每日快走或慢跑5km以上等。对照组:口服磺脲类+双胍类+罗格列酮或吡格列酮,控制饮食、加强运动。跟踪随访8年,观察并记录血管并发症发生情况。 结果 治疗组冠心病、视网膜病变和周围神经病变发生率低于对照组(P<0.05)。糖尿病肾病、脑梗死发生率两组差异无统计学意义(P>0.05)。 结论 2型糖尿病口服降糖药失效后应尽快采用注射胰岛素、加强运动、控制饮食、减轻体重等干预治疗,可明显减少血管并发症发生。

  【关键词】糖尿病,2型;口服降糖药失效;并发症;干预治疗

  Analysis on the vascular complications and related risk factors of insulin therapy for T2DM patients with secondary failure of oral hypoglycemic agents CHEN Shu-ming, CHEN Jing-yan. Shuangliu People’s Hospital, Chendu 610200, China

  Corresponding author: CHEN Shu-ming, E-mail: yiqing56@21cn.com.

  【Abstract】Objective To observe the vascular complications and related risk factors of insulin therapy for T2DM patients with secondary failure of oral hypoglycemic agents. Methods The 453 T2DM patients with failure of oral hypoglycemic agents were divided into two groups, 232 in the treatment group and 221 in the control group. The treatment group was treated with insulin injection to strictly control the fasting plasma glucose in the range of 6mmol/L, on the diet of intake of 25kcal/kg everyday, and walking for more than 5km daily. The control group was treated with oral sulfaurea drugs + biguanide + rosigoitazone or pioglitation, diet, and exercises. Both groups were followed up for 8 years for observing the possible vascular complications. Results The treatment group had a lower incidence of coronary heart disease, and retinopathy and peripheral neuropathy (P<0.05). There was no difference between the two groups in the incidence of cerebral infarction and nephropathy (P>0.05). Conclusion The T2DM patients with failure of oral hypoglycemic agents should be treated by insulin injection, exercises, diet control, and reducing body weight as soon as possible, in case of which, the incidence of vascular complications is significantly to be less.

  【Key words】Diabetes mellitus, type 2; Failure of the oral hypoglycemic agents; Complication; Intervention

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