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所有入选患者均接受胰岛素泵治疗两周。分为吡格列酮、二甲双胍联合胰岛素组和胰岛素组。记录两组患者的每日血糖监测结果(三餐前、三餐后两小时及睡前血糖)。计算出每组患者的达标率及治疗两周后的胰岛素日用量。治疗两周后,insulin组的血糖达标率为60%(9/15),pioglitazone+met+insulin组的血糖达标率为94.7%(18/19),两组具有显著性的统计学差异(P<0.05)。insulin组胰岛素的日平均用量为(23.1±11.8)μ,pioglitazone+met+insulin组胰岛素的日平均用量为(9.5±7.2)μ,两组具有显著性的统计学差异(P<0.05)。治疗两周后,insulin组有1人(6.7%)停用胰岛素治疗,pioglitazone+met+insulin组有6人(31.6%)停用胰岛素治疗,两组具有显著性的统计学差异(P<0.05)。pioglitazone+met+insulin组患者4人有胃肠道反应但可以耐受。insulin组无胃肠道反应。结论初诊的肥胖糖尿病患者,早期联合吡格列酮、二甲双胍和胰岛素治疗,使更多患者血糖达标,并节约胰岛素用量。同时,吡格列酮、二甲双胍具有较好的耐受性和治疗依从性。
All patients were treated with insulin pump for two weeks. Divided into pioglitazone, metformin combined insulin group and insulin group. The daily blood glucose monitoring results of both groups were recorded (before meals, two hours after three meals and blood glucose before bedtime). Calculate the compliance rate of each group of patients and the amount of insulin after two weeks of treatment. Two weeks after treatment, the blood glucose level was 60% (9/15) in the insulin group and 94.7% (18/19) in the pioglitazone + met + insulin group, with significant statistical difference (P <0.05). The mean daily insulin dosage in insulin group was (23.1 ± 11.8) μ, while that in pioglitazone + met + insulin group was (9.5 ± 7.2) μ. There was a significant statistical difference between the two groups (P <0.05). After two weeks of treatment, insulin was discontinued in 1 of the insulin groups (6.7%), insulin was discontinued in 6 of 6 (31.6%) patients in the pioglitazone + met + insulin group, with significant differences between the two groups (P <0.05 ). Four of the patients in the pioglitazone + met + insulin group had gastrointestinal reactions but were tolerated. There was no gastrointestinal reaction in insulin group. Conclusions Early diagnosis of obese diabetic patients, early combination of pioglitazone, metformin and insulin therapy, so that more patients with blood glucose compliance, and save insulin dosage. At the same time, pioglitazone and metformin have better tolerability and therapeutic compliance.