摘要
目的:观察甘精胰岛素治疗罗格列酮与二甲双胍降糖不佳的2型糖尿病患者的效果。方法:选择2013年8月-2015年12月于我院接受治疗的经罗格列酮与二甲双胍降糖不佳的2型糖尿病患者90例,按随机数字表法分为对照组与观察组,各45例。对照组患者给予阿卡波糖片50mg餐前口服,tid,最大剂量为300mg/d;观察组患者给予甘精胰岛素注射液皮下注射,qd,起始剂量为0.15u/kg,以后根据血糖监测结果对剂量进行调整,最大剂量为40u/d。两组患者均治疗24周。比较两组患者治疗前后的空腹血糖、餐后2h血糖、糖化血红蛋白(HbA_1c)、空腹C肽和餐后2hC肽水平,记录患者血糖达标时间和不良事件发生情况,并计算不良事件发生率。结果:治疗前,两组患者的上述指标比较,差异均无统计学意义(P>0.05)。治疗后,两组患者的空腹血糖和餐后2h血糖水平均显著低于治疗前,空腹C肽、餐后2hC肽和HbA_1c水平均显著高于治疗前;且除空腹血糖外,观察组患者上述指标均显著优于对照组,差异均有统计学意义(P<0.05)。观察组患者血糖达标时间显著短于对照组,夜间低血糖、严重低血糖、水肿、胃肠道反应以及总不良事件的发生率均显著低于对照组,差异均有统计学意义(P<0.05)。结论:甘精胰岛素用于治疗罗格列酮与二甲双胍降糖效果不佳的2型糖尿病患者,能有效降低其血糖和HbA_1c水平,改善胰岛功能,且安全性较高。
OBJECTIVE： To observe the effects of insulin glargine in type 2 diabetes mellitus patients with poor glucose con- trol by rosiglitazone and metformin. METHODS： A total of 90 patients with type 2 diabetes mellitus with poor glucose control by rosiglitazone and metformin admitted to our hospital from Aug. 2013 to Dee. 2015 were divided into control group and observation group according to random number table, with 45 cases in each group. Control group was given Acarbose tablets 50 mg orally be- fore meal, tid, with maximal dose of 300 mg/d. Observation group was given Insulin glargine injection subcutaneously, qd, with initial dose of 0.15 u/kg, adjusted according to blood glucose monitoring, with maximal dose of 40 u/d. Both group were treated for 24 weeks. The levels of fasting blood glucose, 2 h postprandial blood glucose, HbA1c, fasting C peptide and 2 h postprandial C peptide were compared between 2 groups before and after treatment. The time of blood glucose reaching target and the occur- rence of adverse events were recorded, and the incidence of adverse events was calculated. RESULTS ： Before treatment, there was no statistical significance in above indexes between 2 groups （P〉0.05）. After treatment, The levels of fasting blood glucose and 2 h postprandial blood glucose in 2 groups were significantly lower than before treatment, and the levels of fasting C peptide, 2 h postprandial C peptide and HbA1c were significantly higher than before treatment; except for fasting blood glucose, above indexes of observation group were significantly better than those of control group, with statistical significance （P〈0.05）. The time of blood glucose reaching target in observation group was significantly shorter than control group, the incidence of nocturnal hypoglycemia, severe hypoglycemia, edema and gastrointestinal reactions and total adverse events in observation group were significantly lower than control group, with statistical significance （P〈0.05）. CONCLUSIONS： The application of insulin glargine in type 2 diabetes mellitus patients with poor glucose control by rosiglitazone and metformin can effectively reduce the levels of blood glucose and HbAxc, and improve islet function with good safety.
出处
《中国药房》
CAS
北大核心
2017年第35期4960-4962,共3页
China Pharmacy
关键词
甘精胰岛素
罗格列酮
二甲双胍
2型糖尿病
降糖
胰岛功能
Insulin glargine
Rosiglitazone
Metformin
Type 2 diabetes mellitus
Hypoglycemic
Islet function
