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目的比较格列美脲联合甘精胰岛素与预混胰岛素类似物2种方案治疗血糖显著升高的初诊2型糖尿病患者的疗效与低血糖发生率。方法初诊2型糖尿病患者48例,随机分为混合治疗组(混合组,n=24)和预混胰岛素治疗组(预混组,n=24)。混合组每天早餐前口服格列美脲+每晚睡前皮下注射甘精胰岛素1次,预混组早晚餐前分别皮下注射预混胰岛素类似物,根据空腹血糖(FBG)水平,每2周调整药物剂量,以FBG小于6.1 mmol/L为治疗目标,共治疗12周。结果治疗后2组的FBG和糖化血红蛋白含量均明显下降,但混合组下降幅度大于预混组。混合组发生低血糖事件:前6周共5例(20.8%),后6周共2例(8.3%);预混组:前6周共9例(37.5%),后6周共8例(33.3%)。预混组的胰岛素总用量大于混合组(P<0.01)。结论对于血糖显著升高的初诊2型糖尿病患者,使用甘精胰岛素+格列美脲或预混人胰岛素类似物进行治疗,均能较好控制FBG、糖化血红蛋白,但基础胰岛素+格列美脲较预混胰岛素控制空腹血糖更佳,胰岛素用量少,低血糖事件发生率低。
Objective To compare the efficacy and the incidence of hypoglycaemia in newly diagnosed type 2 diabetic patients with glycerophosphate combined with insulin glargine and premixed insulin analogs. Methods 48 newly diagnosed type 2 diabetic patients were randomly divided into mixed treatment group (n = 24) and premixed insulin treatment group (n = 24). The patients in the mixed group were given oral glimepiride daily before breakfast and insulin glargine was administered subcutaneously once a night at bedtime. The pre-mixed group was injected subcutaneously with insulin analogue before and after meals, and adjusted every two weeks according to the level of fasting blood glucose (FBG) Drug dose, with FBG less than 6.1 mmol / L for the treatment of a total of 12 weeks. Results After treatment, the content of FBG and HbA1c in both groups decreased significantly, but the decrease in the mixed group was greater than that in the premixed group. In the mixed group, hypoglycemic events occurred in 5 cases (20.8%) in the first 6 weeks and 2 cases (8.3%) in the last 6 weeks. In the pre-mixed group, 9 cases (37.5%) in the first 6 weeks and 8 cases (33.3%). The total amount of insulin in the premixed group was greater than that in the mixed group (P <0.01). Conclusions FBG, HbA1c, but basal insulin + glimepiride are better controlled in patients with newly diagnosed type 2 diabetes with markedly elevated blood glucose when treated with insulin glargine + glimepiride or pre-mixed insulin analogs Better than the premixed insulin control of fasting blood glucose, insulin dosage, low incidence of hypoglycemia.