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了解甘精胰岛素或中效胰岛素联合二甲双胍治疗对口服降糖药血糖控制不佳的2型糖尿病患者的疗效和安全性。符合纳入标准的60例2型糖尿病患者分成A、B两组,每组各30例。A组用甘精胰岛素联合二甲双胍治疗,B组用中效胰岛素联合二甲双胍治疗,共12周。治疗前后分别测空腹血糖(FPG)、餐后2h血糖(PPG)以及糖化血红蛋白(HbA1c)水平,了解治疗期间两组低血糖的发生情况。两组治疗后较治疗前的FPG、PPG和HbA1c水平降低,差异有统计学意义(P<0.05)。两组治疗后HbA1c水平<7.0%的百分率分别为53.3%和40.0%,差异无统计学意义(P>0.05),两组治疗前HbA1c水平≥7%～<9%的患者,治疗后HbA1c<7.0%的百分率分别为70.6%和62.5%,差异无统计学意义(P>0.05)。两组的轻微低血糖发生率相似(P>0.05)。甘精胰岛素或中效胰岛素联合二甲双胍治疗对口服降糖药控制不佳的2型糖尿病患者可以进一步降低血糖和糖化血红蛋白水平,低血糖发生率低。甘精胰岛素或中效胰岛素联合二甲双胍治疗是口服降糖药控制不佳的2型糖尿病患者安全有效的治疗方案,而中效胰岛素作为基础胰岛素治疗更是廉价而有效的选择。
To understand the efficacy and safety of insulin glargine or insulin plus metformin in patients with type 2 diabetes who are poorly controlled by oral hypoglycemic agents. Sixty patients with type 2 diabetes who met the inclusion criteria were divided into groups A and B, with 30 patients in each group. Group A was treated with insulin glargine and metformin, and group B was treated with mid-dose insulin plus metformin for 12 weeks. Before and after treatment, fasting blood glucose (FPG), postprandial 2h blood glucose (PPG) and HbA1c levels were measured to understand the incidence of hypoglycemia in both groups during treatment. The levels of FPG, PPG and HbA1c in both groups after treatment were lower than those before treatment, the difference was statistically significant (P <0.05). The percentages of HbA1c levels <7.0% were 53.3% and 40.0% respectively in two groups (P> 0.05), and the levels of HbA1c in patients before and after treatment were higher than 7% ~ <9% 7.0% were 70.6% and 62.5%, respectively, with no significant difference (P> 0.05). The incidence of mild hypoglycemia was similar in both groups (P> 0.05). Patients with type 2 diabetes who are under the control of oral hypoglycemic agents with glargine or midline insulin plus metformin can further lower their blood glucose and glycosylated hemoglobin levels and have a lower incidence of hypoglycaemia. Glargard or intermediate-acting insulin combined with metformin is a safe and effective treatment for patients with type 2 diabetes who are poorly controlled by oral hypoglycemic agents, and intermediate-acting insulin is a cheap and effective alternative to basal insulin therapy.