米格列奈与瑞格列奈分别联合二甲双胍在新诊断2型糖尿病的临床价值比较

目的：探讨米格列奈和瑞格列奈在治疗新诊断2型糖尿病的临床价值比较。方法：将2010年1月至2012年12月间我院新诊断的120例2型糖尿病患者随机分为A、B两组，其中A组患者60例，采用瑞格列奈联合二甲双胍进行治疗，B组患者60例，采用米格列奈联合二甲双胍进行治疗。对两组患者血糖水平及12周后相应指标进行统计分析。结果：治疗3天后两组患者的空腹血糖及餐后血糖水平明显低于治疗前，B组患者血糖降低幅度大于A组（P〈0．05）；治疗12周后，两组空腹血糖及餐后血糖水平显著减小，B组减小程度高于A组；患者空腹及餐后胰岛素水平有一定的增加，B组增加程度高于A组；B组患者HbAlc的降低程度高于A组；两组同时还可以降低HOMA胰岛素的抵抗指数以及增大胰岛素的敏感指数，其中B组效果好于A组；B组患者出现低血糖的人次少于A组。结论：米格列奈与瑞格列奈分别联合二甲双胍可以短期降低新诊断2型糖尿病患者的血糖水平，在中期治疗后米格列奈联合二甲双胍可以更有效的改善患者糖尿病的各项指标。

Effects of Mitiglinide and Repaglinide with Metformin in Newly Diagnosed Type 2 Diabetic Patients

Objective： To compare the effects of mitiglinide and repaglinide on newly diagnosed T2DM patients. Methods： 120 newly diagnosed T2DM patients were divided randomly into Group A and Group B. Group A accepted a therapy with repaglinide plus metformin, while Group B with mitiglinide plus metformin. The glucose level and indexes of patients were analyzed. Results： 3 days lat- er, fasting blood glucose levels at lh, 2h and 3h after meals decreased in both groups. The mitiglinide group had a higher decreasing （P〈0.05）. 12 weeks later, FBG and postprandial blood glucose decreased conspicuously in both groups （P〈0.05）, and mitiglinide group decreased even more than repaglinide group （P〈0.05）. Fasting insulin and postprandial insulin increased, especially in mitiglinide group （P〈0.05）. Glycosylated hemoglobin-Alc （HbAlc） in both groups decreased （P〈0.05）. In both groups, the level of HOMA insulin resis- tance （HOMA-IR） decreased significantly, and the level of insulin sensitive index （ISI） increased （P〈0.05）, which increased more obvi- ously in mitiglinide group （P〈0.05）. Conclusion： For newly diagnosed T2DM, both mitiglinide and repaglinide can decrease FBG and postprandial blood glucose significantly in a short term. After a long period of therapy, mitiglinide combined with metformin could im- prove the diabetes indexes effectively.