·糖尿病临床研究·

　地特胰岛素联合二甲双胍或加用瑞格列奈治疗口服降糖药血糖控制不佳的2型糖尿病患者的疗效观察

　　唐建东 李清楚 康志强 何丽 罗方 雷龙涛

　　【摘要】目的 观察地特胰岛素(诺和平)联合二甲双胍(格华止)或瑞格列奈(诺和龙)治疗口服降糖药(OAD)血糖控制不佳的T2DM患者疗效。方法 选取OAD血糖控制不佳的T2DM患者42例，给予地特胰岛素联合二甲双胍治疗，血糖未达标再加用瑞格列奈，患者分为地特胰岛素联合二甲双胍组(A组)和地特胰岛素联合二甲双胍加用瑞格列奈组(B组)，分别于治疗前后测定SBP、DBP、BMI、TG、TC、LDL-C、HDL-C、HbA1c、平均血糖水平(MBG)及日内平均血糖波动幅度(MAGE)。结果 治疗后两组TG、HbA1c、MBG、MAGE均较治疗前改善(A组：t=2.304、2.421、2.610、2.56;P=0.031、0.030、0.023、0.027;B组：t=2.204、2.107、3.103、2.893;P=0.035、0.028、0.017、0.020)。结论 地特胰岛素联合二甲双胍或加用瑞格列奈能有效改善OAD控制不佳的T2DM患者的血糖控制情况。

　　【关键词】糖尿病，2型;血糖控制;地特胰岛素;二甲双胍;瑞格列奈

Effect of insulin detemir combined with metformin or sequential treatment with repaglinide on T2DM patients with poor glycemic controls Tang Jian-dong, Li Qing-chu, Kang Zhi-qiang, et al. Department of Endocrinology, Zhengzhou Central Hospital, Zhengzhou 450007, China

　　【Abstract】Objective To observe the effect of insulin detemir combined with metformin or sequential treatment with repaglinide on the T2DM patients with poorly controlled blood glucose from oral anti-diabetes drugs (OAD). Methods Forty-two T2DM patients with poorly controlled blood glucose were observed in this study. They were treated with insulin detemir combined with metformin, in case the blood glucose was not controlled to the targeted level, the sequential treatment with repaglinide would be added. The patients in group A was treated with insulin detemir combined with metformin, and those in group B treated with insulin detemir + metformin and repaglinide in the added treatment. Before and after treatment, the SBP, DBP, BMI, HbA1c, TG, TC, HDL-C, LDL-C, and mean blood glucose (MBG) levels, and the mean amplitude of glycemic excursions (MAGE) were determined in all patients for 12 weeks for comparison. Results After the treatment，the HbA1c and MBG levels and MAGE of both groups were significantly decreased. Group A: t=2.421, 2.610, 2.56; P=0.030, 0.023, 0.027; Group B: t=2.107, 3.103, 2.893; P=0.028, 0.017, 0.020. Conclusion Insulin detemir combined with metformin or sequential treatment with repaglinide can significantly improve the glycemic control of the T2DM patients with poorly controlled blood glucose from OAD.

　　【Key words】Diabetes mellitus, type 2; Glycemic control; Insulin detemir; Metformin; Repaglinide