论文部分内容阅读
目的比较甘精胰岛素联合二甲双胍或/和吡格列酮治疗初诊2型糖尿病(T2DM)的疗效及安全性。方法初诊T2DM先单用二甲双胍(1.0g/d)治疗4周,血糖控制不佳的98例患者随机分为3组。A组:二甲双胍+甘精胰岛素,B组:吡格列酮+甘精胰岛素,C组:二甲双胍+吡格列酮+甘精胰岛素,治疗随访12周。结果 12周后3组患者的空腹血糖(FPG)全部达标,餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)均比治疗前明显降低,A、B两组HbA1c部分达标,C组HbA1c达标(P﹤0.05)。C组疗效优于A、B组,FPG达标所需时间最短,日胰岛素用量最少。3组低血糖发生率均﹤3.5%,无严重低血糖,差异无统计学意义(P﹥0.05)。结论甘精胰岛素联合二甲双胍或/和吡格列酮均能较好地控制血糖,低血糖发生率低,三药联合疗效优于二药联合,安全有效是初诊T2DM理想的治疗方案。
Objective To compare the efficacy and safety of insulin glargine combined with metformin and / or pioglitazone in the treatment of newly diagnosed type 2 diabetes mellitus (T2DM). Methods The newly diagnosed T2DM patients were treated with metformin (1.0g / d) for 4 weeks and 98 patients with poor blood glucose control were randomly divided into 3 groups. Group A: metformin + insulin glargine, group B: pioglitazone + insulin glargine, group C: metformin + pioglitazone + insulin glargine for 12 weeks. Results After 12 weeks, fasting plasma glucose (FPG) was achieved in all three groups, and 2hPG and HbA1c in both groups were significantly lower than those before treatment. The HbA1c levels in groups A and B were up to standard, and the levels of HbA1c in group C were up to standard P <0.05). C group curative effect is better than A, B group, FPG compliance shortest time required, daily insulin dosage at least. The incidence of hypoglycemia in the three groups were all less than 3.5%, without severe hypoglycemia, the difference was not statistically significant (P> 0.05). Conclusion Both glargine and metformin and / or pioglitazone can control blood sugar well, and the incidence of hypoglycemia is low. The combined effect of three drugs is superior to the combination of two drugs. It is safe and effective to treat T2DM with newly diagnosed T2DM.