甘精胰岛素联合阿卡波糖治疗继发性磺脲类药物失效的2型糖尿病30例疗效观察

目的:探讨采用甘精胰岛素与阿卡波糖联合治疗2型糖尿病(T2DM)经磺脲类药物继发失效(SFS)的效果。方法:选择2017年2月至2019年2月上饶市第二人民医院收治的60例SFS的T2DM患者作为研究对象,采用随机数表法分为两组,各30例。对照组采用甘精胰岛素联合格列美脲治疗,观察组在对照组基础上加用阿卡波糖治疗,比较两组血糖水平及胰岛功能,统计两组治疗期间不良反应发生情况。结果:治疗后,两组糖化血红蛋白(HbA1c)、餐后2 h血糖(2 hPG)、空腹血糖(FBG)水平均比治疗前低,且观察组低于对照组(P<0.05);治疗后,两组胰岛β细胞功能指数(HOMA-β)水平均提升,且观察组高于对照组,差异有统计学意义(P<0.05);治疗后,两组胰岛素抵抗指数(HOMA-IR)水平均比治疗前低,且观察组低于对照组(P<0.05);两组治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论:T2DM患者经SFS后采用甘精胰岛素与阿卡波糖联合治疗有较好的治疗效果,利于改善血糖水平,提升胰岛功能,且未增加不良反应发生,安全性好。

Clinical Observation of Insulin Glargine Combined with Acarbose in the Treatment of 30 Cases of Type 2 Diabetes Mellitus with Secondary Sulfonylurea Drug Failure

Objective:To explore the effects of insulin glargine injection combined with acarbose tablets in treatment of type 2 diabetes mellitus(T2DM)after secondary failure to sulfonylureas(SFS).Methods:60 cases of SFS patients with T2DM admitted to Shangrao Second People's Hospital from February 2017 to February 2019 were selected and randomly divided into two groups,30 cases in each group.The control group was treated with insulin glargine combined with glimepiride,and the observation group was treated with acarbose on the basis of the control group.The blood glucose level and islet function of the two groups were compared,and the incidence of adverse reactions during the treatment of the two groups was counted.Results:After treatment,the levels of glycated hemoglobin(HbA1c),2 hours postprandial blood glucose(2 hPG)and fasting blood glucose(FBG)in both groups were lower than those before treatment,and observation group was lower than control group(P<0.05);After treatment,the homeostasis model assessmentβ(HOMA-β)level in both groups was increased,and observation group was higher than control group,the difference was statistically significant(P<0.05);After treatment,the level of homeostasis model assessment-insulin resistance index(HOMA-IR)in both groups was decreased than those before treatment,and observation group was higher than control group(P<0.05);there was no statistical significant difference in the comparison of incidence of adverse reactions between the two groups during treatment.Conclusion:Insulin glargine injection combined with acarbose tablets in the treatment of T2DM patients after SFS has better curative effects,it is beneficial to improve the level of blood glucose and increase pancreatic islet function,and it will not increase the occurrence of adverse reactions,with high safety.