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目的:探讨格列美脲联合预混胰岛素对治疗2型糖尿病的临床效果。方法:选择2012年6月—2014年6月于解放军第463医院内分泌科住院的60例2型糖尿病患者,曾单独使用预混胰岛素治疗,血糖控制不佳,分为对照组和治疗组,每组患者30例。两组患者均给予门冬胰岛素30注射液早晚餐前注射治疗,对照组加用二甲双胍口服,治疗组患者加用格列美脲。两组患者观察12周后,观察两组患者的空腹及餐后血糖、糖化血红蛋白、体重指数、胰岛素用量变化情况。结果:两组患者分别治疗12周后,较治疗前空腹及餐后血糖、糖化血红蛋白、胰岛素用量均明显降低(P<0.05),体重指数无明显变化(P>0.05),格列美脲组血糖及糖化血红蛋白下降、低血糖发生与二甲双胍组类似(P>0.05),胰岛素用量较二甲双胍组明显减少(P<0.05)。结论:在使用预混胰岛素剂量偏大且血糖控制不佳的2型糖尿病患者中,如无法联用二甲双胍,可联合应用格列美脲,其降糖疗效确切,且能减少胰岛素用量,不明显增加患者低血糖及体重指数。
Objective: To investigate the clinical effect of glimepiride combined with premixed insulin in the treatment of type 2 diabetes mellitus. Methods: From June 2012 to June 2014, 60 patients with type 2 diabetes who were hospitalized in Department of Endocrinology, 463 Hospital of People’s Liberation Army were treated with premixed insulin alone and their blood glucose control was poor. They were divided into control group and treatment group Group of 30 patients. Two groups of patients were given insulin aspart 30 injection of morning and evening before injection, the control group plus metformin oral, the treatment group with glimepiride. After 12 weeks of observation, the two groups of patients were observed fasting and postprandial blood glucose, glycosylated hemoglobin, body mass index, insulin dosage changes. Results: After 12 weeks treatment, the fasting and postprandial blood glucose, glycosylated hemoglobin and insulin dosage were significantly decreased (P <0.05) and no significant changes in body mass index (P> 0.05). The glimepiride group Blood glucose and HbA1c decreased, and hypoglycemia was similar to that of metformin (P> 0.05). The dosage of insulin was significantly lower than that of metformin (P <0.05). CONCLUSIONS: In patients with type 2 diabetes who are predisposed to high doses of insulin and poor glycemic control, if glyformin can not be used in combination with glimepiride, its hypoglycemic effect is accurate and insulin dosage is reduced, with no apparent effect Increase in patients with low blood sugar and body mass index.