甘精胰岛素联合瑞格列奈与胰岛素泵治疗对2型糖尿病疗效比较

Comparison on therapeutic effects of repaglinide with insulin glargine and insulin pump on type 2 diabetes mellitus

摘要:

目的：探讨甘精胰岛素联合瑞格列奈与胰岛素泵治疗初诊2型糖尿病的疗效。方法：选择60例初诊2型糖尿病，随机分为瑞格列奈联合甘精胰岛素组和胰岛素泵组，根据血糖水平调整用药量。观察两组治疗前后空腹血糖（fasting blood glucose，FBG）、餐后2 h血糖（2-hour postprandial plama glucose，2 h PG）、糖化血红蛋白A1c（glycosylated hemoglobin A1c，HbA1c）和血脂变化情况。结果：治疗后A组和B组患者FBG、2 h PG、HbA1c均较治疗前明显下降（P值A组分别为0.000 3、0.000 1和0.000 2，B组为0.000 4、0.000 2和0.000 2，P＜0.05）；治疗后A组与B组总甘油三酯（total triglycerides，TG）水平明显降低，总胆固醇（total cholesterol，TC）和低密度脂蛋白-胆固醇（low density lipoprotein-cholesterol，LDL-C）也轻度下降，高密度脂蛋白-胆固醇（high density lipoprotein-cholesterol，LDL-C）轻度升高，组间FBG、2 h PG、HbA1c、TC、TG、HDL-C和LDL-C比较均无统计学差异（P值分别为0.42、0.24、0.35、0.48、0.17、0.54和0.54，P ＞0.05）。结论：甘精胰岛素联合瑞格列奈是治疗初诊2 型糖尿病患者的理想方案，与胰岛素泵持续皮下输注疗效相当。

Abstract:

Objective：To investigate therapeutic effects of repaglinide with insulin glargine and insulin pump in the treatment of type 2 diabetes mellitus. Methods：Totally 60 patients preliminary diagnosed as type 2 diabetes were randomly divided into two groups. Pa－tients in the two groups respectively accepted repaglinide with insulin glargine therapy and insulin pump therapy. Ｔhe dosage was ad－justed on the basis of blood glucose level. Changes in fasting blood glucose（FBG），2-hour postprandial plama glucose（2 h PG），rate of glycosylated hemoglobin A１c（HbA１c） and blood lipid of two groups before and after therapy were observed and compared. Results：Levels of FBG，2 h PG and rate of HbAlc were significantly degraded after the therapy（P=0.000 3，0.000 1，0.000 2；P=0.000 4，0.000 2，0.000 2；P＜0.05）. Levels of total triglyceride（TG），total cholesterol（TC） and low density lipoprotein-cholesterol（LDL-C） were decreased and levels of high density lipoprotein-cholesterol（HDL-C） were increased. There was no statistical difference in FBG，2 h PG，HbA1c，TC，TG，HDL-C and LDL-C between both groups（P=0.42，0.24，0.35，0.48，0.17，0.54，0.54，P ＞0.05）. Conclusions：Repaglin－ide with insulin glargine schedule is an ideally therapy for type 2 diabetes and its curative effect is equivalence to insulin pump.