甘精胰岛素联合格列美脲治疗在改善长期2型糖尿病患者血糖水平和药物耐受中的应用

摘要

目的 探讨甘精胰岛素联合格列美脲治疗在改善长期2型糖尿病患者血糖水平和药物耐受中的应用价值.方法 前瞻性选取2014年1月至2017年1月期间治疗的长期2型糖尿病患者136例,采用随机数字表法将其分为两组,各68例.观察组采用甘精胰岛素联合格列美脲治疗,对照组采用精蛋白生物合成人胰岛素联合格列美脲治疗.比较两组血糖水平、胰岛功能与药物耐受情况的差异.结果 治疗前,两组空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)水平比较,差异无统计学意义(P>0.05);治疗后,全部患者上述指标均明显低于治疗前,其中观察组上述指标均明显低于对照组,比较差异具有统计学意义(P<0.05).观察组血糖总体达标率(92.65％)明显高于对照组(80.88％),两组比较差异具有统计学意义(P<0.05).治疗前,两组空腹胰岛素(Fins)、餐后2 h胰岛素(2Pins)、空腹C肽(FCP)、餐后C肽(PCP)、胰岛素分泌指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)水平比较差异无统计学意义(P>0.05),治疗后,全部患者Fins、2Pins、FCP、PCP、HOMA-β均明显高于治疗前,观察组上述指标均明显高于对照组(P<0.05),全部患者HOMA-IR明显低于治疗前(P<0.05).观察组低血糖事件发生率明显高于对照组,P<0.05.结论 甘精胰岛素联合格列美脲治疗有助于理想控制长期2型糖尿病患者血糖水平,改善胰岛功能,且药物耐受性较佳,值得临床推广应用.%Objective To discuss the application value of Insulin Glargine combined Glimepiride therapy for improving blood - glucose levels and drug resistance in patients with long - term type 2 diabetes. Methods 136 cases patients with long - term type 2 diabetes during the period of January 2014 to January 2017 were selected and divided into two groups by random number table method,68 cases in each group. The observation group were given Insulin Glargine combined Glimepiride therapy,and control group were given protamine biosynthetic human insulin combined Glimepiride therapy. Blood glucose level,islet function and drug resistance situation between the two groups were compared. Results Before treatment,fasting blood glucose (FBG),2 h postprandial blood glucose (2 h PBG),glycosylated hemoglobin (HbA1c)levels between the two groups had no statistically significant difference (P > 0. 05),after treatment,the above indicators of all patients were significantly lower than those of pre - therapy,the indexes of observation group were obviously lower than those of the control group with statistically significant differ-ences (P < 0. 05). The blood glucose overall success rate of observation group (92. 65％)was significantly higher than that of the control group (80. 88％)with statistically significant difference (P < 0. 05). Before treatment,two groups of fasting insulin (Fins),2 h postprandial insulin (2Pins),fasting C peptide (FCP),postprandial c - peptide (PCP),homeostasis model assessment - β (HOMA - β),homeostasis mod-el assessment insulin resistance (HOMA - IR)levels compared between the two group had no statistically significant difference(P > 0. 05),after treatment,Fins,2 Pins,FCP,PCP,HOMA - β of all patients were significantly higher than those of pre - therapy,the above indexes of observa-tion group were obviously higher than those of control group(P < 0. 05),HOMA - IR of all patients were significantly lower than those of pre -therapy (P < 0. 05). Hypoglycemic events of observation group was obviously higher than that of control group(P < 0. 05). Conclusion Insulin Glargine combined Glimepiride therapy helps to ideal control blood - glucose levels,improve islet function for patients with long - term type 2 dia-betes insulin,and drug resistance is better. It is worthy of clinical popularization and application.