摘要
目的探讨甘精胰岛素联合阿卡波糖和二甲双胍治疗磺脲类药物失效型2型糖尿病的可行性。方法选取2018年11月至2020年4月本院收治的100例磺脲类药物失效型2型糖尿病患者作为研究对象,按照奇偶数法分为常规组和研究组,每组50例。常规组采用甘精胰岛素+阿卡波糖治疗,研究组采用甘精胰岛素+阿卡波糖+二甲双胍治疗,比较两组空腹血糖水平、餐后2 h血糖水平、糖化血红蛋白水平、胰岛素抵抗指数、胰岛β细胞功能指数、空腹胰岛素、血糖达标时间、单日胰岛素用量及不良反应发生率。结果治疗前,两组空腹血糖、餐后2 h血糖及糖化血红蛋白水平比较差异均无统计学意义;治疗后,研究组空腹血糖、餐后2 h血糖及糖化血红蛋白水平均低于常规组,差异有统计学意义(P<0.05)。治疗前,两组胰岛素抵抗指数、胰岛β细胞功能指数及空腹胰岛素水平比较差异无统计学意义;治疗后,研究组胰岛素抵抗指数、空腹胰岛素水平均低于常规组,胰岛β细胞功能指数高于常规组,差异有统计学意义(P<0.05);研究组血糖达标时间短于常规组,单日胰岛素用量少于常规组,差异有统计学意义(P<0.05)。研究组不良反应发生率低于常规组,差异有统计学意义(P<0.05)。结论针对磺脲类药物失效型2型糖尿病患者,采用甘精胰岛素+阿卡波糖+二甲双胍3种药物联合治疗模式,可有效降低血糖水平,提升胰岛β细胞功能,且不良反应少,安全性高,值得临床推广运用。
Objective To explore the feasibility of insulin glargine combined with acarbose and metformin in treating sulfonylurea ineffective type 2 diabetes mellitus.Methods 100 patients with type 2 diabetes with sulfonylurea drug failure received by our hospital from November 2018 to April 2020 were selected as the research subjects,and they were divided into the routine group and the study group according to the odd-even method,with 50 cases in each group.The routine group was treated with insulin glargine+acarbose,and the study group was treated with insulin glargine+acarbose+metformin,fasting blood glucose level,2 h postprandial blood glucose level,glycated hemoglobin,insulin resistance index,insulin cell function,fasting insulin level,blood glucose compliance time,daily insulin dosage and incidence of adverse reactions were compared between the two groups.Results Before treatment,there was no significant difference between the two groups in fasting blood glucose,2 h postprandial blood glucose and glycated hemoglobin levels.After treatment,the fasting blood glucose level,2 h postprandial blood glucose level and glycosylated hemoglobin levels in the study group were lower than those in the routine group,and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in insulin resistance index,islet beta cell function index and fasting insulin level between the two groups;after treatment,the insulin resistance index and fasting insulin level in the study group were lower than those in the routine group,and the islet beta cell function index was higher than that in the routine group,the difference was statistically significant(P<0.05).The time of reaching the standard of blood glucose in the study group was shorter than that in the routine group,and the daily insulin dosage was less than that in the routine group,the difference was statistically significant(P<0.05).The incidence of adverse reactions in the study group was lower than that in the routine group,the difference was statistically significant(P<0.05).Conclusion For patients with sulfonylurea failure type 2 diabetes,insulin glargine plus acarbose and metformin can effectively reduce blood glucose level,improve islet cell function,with few adverse reactions and high safety,which is worthy of clinical application.
作者
王琳
杨爽
曲荥荥
WANG Lin;YANG Shuang;QU Yingying(Department of Endocrinology,Lighthouse Central Hospital,Liaoyang,Liaoning,111300,China)
出处
《当代医学》
2022年第17期27-30,共4页
Contemporary Medicine
