地特胰岛素联合瑞格列奈对2型糖尿病患者血糖波动、氧化应激的影响

摘要

Objective To investigate the levels of blood glucose fluctuation and oxidative stress in type 2 diabetic patients treated with insulin detemir in combination with repaglinide.Methods Sixty diabetic patients were randomly assigned to receive insulin detemir and repaglinide (combine group,n =30) or repaglinide (treatment group,n =30).Meanwhile,another 26 healthy subjects were selected as normal control (control group),which matched the included patients in gender,age and body mass indexes (BMI).The relevant indexes were observed and compared before and after the treatment,including glycosylated hemoglobin (HbA1c),fasting plasma glucose (FPG),2h postprandial blood glucose (2h PG),mean amplitude glycemic excursions (MAGE),mean of daily differences (MODD),malondialdehyde (MDA),superoxide dismutase (SOD).Results The levels of FPG,2hPG,HbA1c,MDA were remarkably higher in both combine group and treatment group than in control group (P ＜0.01),the levels of SOD were lower.After the treatment,the levels PPG,2hPG,HbA1c,MDA,MAGE,MODD in these two groups were significantly lower than before (P ＜ 0.05) ; and the levels of SOD were markedly higher.The levels of MDA,MAGE,MODD,HbA1c were significantly lower in combine group than treatment group,and the levels of SOD were markedly higher (P ＜ 0.05).Conclusion Insulin detemir combined with repaglinide for treating type 2 diabetic patients,could decrease blood glucose fluctuation,and reduce oxidative stress in type 2 diabetic patients.%目的 观察地特胰岛素联合应用瑞格列奈对2型糖尿病患者血糖波动、氧化应激水平的影响.方法 2型糖尿病患者60例随机分为2组,每组30例.联合组给予地特胰岛素联合瑞格列奈治疗,单药组单纯给予瑞格列奈治疗,同时选取性别、年龄、体质量指数(BMI)等一般情况相匹配的健康体检者26例作为健康对照组,观察治疗前后糖化血红蛋白(HbA.c)、空腹血糖(FPG)、餐后2h血糖(2 hPG)、平均血糖波动幅度(MAGE)和日间血糖平均绝对值(MODD)、血丙二醛(MDA)和超氧化物歧化酶(SOD)的变化.结果 与健康对照组比较,治疗前单药组、联合组FPG、2 hPG、HbA1c、MDA均升高,SOD均降低(P＜0.01)；治疗后2组FPG、2 hPG、HbAlc、MDA、MAGE、MODD均较治疗前降低,SOD较治疗前升高(P＜0.05),且联合组MDA、MAGE、MODD、HbA.c下降及SOD升高较单药组更明显(P＜0.05).结论 地特胰岛素联合瑞格列奈治疗2型糖尿病,可减少血糖波动,减轻2型糖尿病患者体内的氧化应激水平.