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甘精胰岛素联合格列美脲对比联合吡格列酮治疗新诊断2型糖尿病的疗效观察

来自:中国糖尿病杂志  编辑: 洪世华 吴菊琴 柯瑞琼 肖丽霞 秦永章|点击数:|2014-12-16

 ·糖尿病临床研究·

   【摘要】 目的 比较甘精胰岛素联合格列美脲或联合吡格列酮治疗新诊断HbA1c>9.0% T2DM患者的疗效性与安全性。 方法 将新诊断的92例T2DM患者随机分为甘精胰岛素联合格列美脲组(A组)和联合吡格列酮组(B组),观察治疗前后,两组BMI、FBG、2 hBG、HbA1c、胰岛β细胞功能、血糖达标时间、胰岛素单日用量及低血糖发生率。 结果 12周后,两组FBG、2 hBG、HbA1c、HOMA-IR均比治疗前下降(P<0.01);FC-P、2 hC-P、胰岛素分泌指数(HOMA-islet)均升高(P<0.01);B组治疗后较治疗前体重增加(P<0.05),而A组无明显变化(P>0.05);与B组比较,A组达标时间短,单日胰岛素用量少、体重增加少且低血糖发生率低(P<0.05)。 结论 甘精胰岛素联合格列美脲与联合吡格列酮治疗新诊断T2DM均能较好地控制血糖,但甘精胰岛素联合格列美脲低血糖发生率更低,体重增加更少。

  【关键词】 糖尿病,2型;甘精胰岛素;格列美脲;吡格列酮

   【Abstract】 Objective To compare the efficacy and safety of glargine plus glimepiride or pioglitazone intensive therapies in newly diagnosed T2DM patients with HbAlc>9%. Methods 92 newly diagnosed T2DM patients were randomly divided into glargine plus glimepiride(A group) and glargine plus pioglitazone(B group). The levels of BMI, FBG, 2 hBG, HbA1c, β-cell function, the time to achieve the target, insulin dose and the incidence rate of hypoglycemia were measured and compared before and after intensive therapy between two groups. Results After 12 weeks of treatment, the level of FBG, 2 hBG, HbAlc and insulin resistance (HOMA-IR) were decreased and FC-P, 2 hC-P and HOMA-IS were increased (P<0.01) in two groups. BMI after treatment in group B was higher than before treatment(P<0.05), but there was no significant difference before and after treatment in group A (P>0.05). The the time to achieve the target, insulin dose, BMI increase and the incidence rate of hypoglycemia was lower in group A than in group B (P<0.05). Conclusion Glargine plus glimepiride or glargine plus pioglitazone intensive therapies both could effectively improve symptom, but the incidence rate of hypoglycemia and BMI increased of glargine plus glimepiride is lower than of glargine plus pioglitazone in the treatment of newly diagnosed T2DM patients.

  【Key words】 Diabetes mellitus, type 2; Glargine; Glimepiride; Pioglitazone

上一篇: 采用动态血糖监测系统评价沙格列汀改善胰岛β细胞功能较差的2型糖尿病患者血糖波动的观察 下一篇: 快速血酮对比尿酮体对糖尿病酮症诊断及治疗的临床意义