瑞格列奈联合甘精胰岛素治疗2型糖尿病的疗效观察

目的 探讨甘精胰岛素联合瑞格列奈治疗2型糖尿病的疗效.方法 将110例2型糖尿病患者随机分为观察组55例和对照组55例.两组患者均给予糖尿病教育、控制饮食、运动疗法等基础治疗,观察组睡前皮下注射甘精胰岛素,初始剂量为0.2U·kg-1·d-1,餐前口服瑞格列奈,3～6 m/d,分3次服用；对照组给予精蛋白生物合成人胰岛素注射液(预混30R),起始剂量0.4U·kg-1 ·d-1,疗程均为3个月.观察两组治疗前后空腹血糖( FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(Homa-IR)、胰岛素分泌指数(Homa-β)、血糖达标时间、低血糖事件.结果 两组治疗后FPG、2hPG、HbA1c、Homa-IR均较治疗前明显降低(均P＜0.01),Homa-β均明显升高(均P＜0.01)；治疗后观察组HbA1c、Homa-IR均较对照组明显下降(t =2.786、3.449,均P＜0.01),Homa-β较对照组明显升高(t=-4.833,P＜0.01)；观察组血糖达标时间明显短于对照组(t =2.126,P＜0.01)；观察组未出现低血糖,对照组出现4例低血糖,观察组低血糖发生率低于对照组(x2 =4.151,P＜0.05).结论 甘精胰岛素联合瑞格列奈能平稳降低血糖至正常水平,并保持血糖稳定,促进胰岛β细胞功能恢复,减轻胰岛素抵抗,减少胰岛素用量,降低不良反应发生,值得临床推广使用.

The observation of the effect of repaglinide combined with insulin glargine in the treatment of patients with type 2 diabetes

Objective To investigate the effect of repaglinide combined with insulin glargine in the treatment of patients with type 2 diabetes. Methods 110 patients with type 2 diabetes were randomly divided into the control group and observation group,each group 55 cases. The control group was given novolin 30R, initial dose of 0.4U ·kg-1·d-1. The observation group was given subcutaneous injection of insulin glargine at bedtime, the initial dose of 0.2U·kg-1·d-1 ,preprandial oral repaglinide,3 of 6mg/d,divided into three doses,two groups were observed for 3 months, the difference of fasting plasma glucose （FPG）, 2h postprandial glucose （2hPG）, glycated hemoglobin （ HbA1 c）, Homa-IR, Homa-13, hypoglycemia, blood glucose time were compared before and after treatment. Results After treatment, FPG,2hPG, HbAlc, Homa-IR were significantly lower than before treatment, and Homa-β was signifi- cantly higher than that before treatment（ all P 〈 0.01 ） ;After treatment, HbA1 c, Homa-IR were lower than the control group significantly （ t = 2.786,3. 449, all P 〈 0.01 ）, and Homa-β was significantly higher than the control group （ t = -4. 833 ,P 〈 0.01 ）;The blood glucose compliance time of the Observation group was significantly shorter than the control group （ t = 2. 126, P 〈 0.01 ） ; The observation group had 0 case of low blood sugar, and the control group had 4 cases of low blood sugar, the difference was statistically significant（ x2 = 4.151, P 〈 0.05 ）. Conclusion Repaglinide combined with insulin glargine in the treatment of patients with type 2 diabetes could quickly reduce blood sugar,reduce blood glucose to normal levels, keep blood sugar stable, restore β-cell function, reduce insulin resistance, reduce insulin dosage, reduce adverse events, and it was worthy of clinical use.