地特胰岛素联合格列齐特缓释片治疗2型糖尿病观察

目的：评价地特胰岛素联合格列齐特缓释片治疗继发性磺脲类降糖药失效（SFS）2型糖尿病患者的疗效及安全性.方法：48例SFS 2型糖尿病患者随机分为地特胰岛素联合格列齐特缓释片（D）组和门冬胰岛素30（R）组进行治疗.观察治疗前后两组体质指数（BMI）和糖化血红蛋白（HbAlc）水平,24h血糖达标时段、24 h平均血糖（MBG）、血糖波动幅度（MAGE）及以及低血糖发生频率及程度等.结果：与治疗前比较,治疗后两组血糖达标时段均明显延长,MBG及HbA1c均明显下降（P＜0.05）;治疗后两组间低血糖发生率差异无统计学意义（P＞0.05）,但D组MAGE及低血糖程度均低于R组（P＜0.05）.结论：地特胰岛素联合格列齐特缓释片能有效控制SFS的2型糖尿病患者血糖,安全性高.

Effect and safety of Insulin Detemir Combined with Gliclazide in the Treatment of type 2 Diabetes Mellitus

Objective：To evaluate the effect and safety of insulin detemir combined with gliclazide sustained-release tablets in the treatment of type 2 diabetes mellitus with secondary failure to sulfonylureas （SFS）.Methods：Totally 48 cases of type 2 diabetes patients with SFS were randomly divided into Dgroup and R group.D group was given insulin detemir combined with gliclazide sustainedrelease tablets,R group was given insulin aspart 30,and the treatment course was 3 months.The target blood glucose reaching time,mean blood glucose（MBG） in 24h and mean amplitude of glycemic excursions（MAGE） before and after the treatment was observed,and the incidence and severity of hypoglycemia were compared.Results：There were statistically significant differences in MBG,MAGE and HbA1 c between the two groups before and after treatment （P 〈 0.05）.There was not statistically significant differences in the incidence of hypoglycemia between the two groups after treatment（P 〉0.05）,while compared with R group,the severity of hypoglycemia and MAGE were both lower in D group（P 〈0.05）.Conclusion：For the T2DM inpatients,with SFS,the treatment with insulin detemir combined with gliclazide sustained-release tablets can improve glucose control significantly with good safety.