甘精胰岛素及诺及灵N分别及格列美脲联合治疗2型糖尿病疗效比较.docVIP

甘精胰岛素及诺及灵N分别及格列美脲联合治疗2型糖尿病疗效比较【摘要】 目的 比较甘精胰岛素和诺和灵N分别与格列美脲联用治疗2型糖尿病患者的疗效。方法 选择40例口服降糖药治疗至少3个月而血糖控制不佳（HBA1c7.0 %）的2型糖尿病患者自选睡前注射一次甘精胰岛素或诺和灵N联用格列美脲2～4 mg早晨一次口服治疗16周。比较甘精胰岛素组或诺和灵N组治疗前后FPG和HbA1c的变化并评估两组间的差异性。结果 治疗16周时，甘精胰岛素组和诺和灵N组的HbA1c值分别下降1．9±0．8%和1．8±0．9%(P=0．6864)，空腹血糖水平分别下降3．5±1．4 mmol/L和3．1±1．5 mmol/L(P=0．4373)，两组疗效间的差异均无统计学意义。甘精胰岛素组较诺和灵N组发生症状性低血糖人数(6/14vs14/6; P=0．0105)和发生夜间低血糖次数(6vs31;P=0．0040)都显著性减少。结论 睡前注射一次甘精胰岛素或诺和灵N联用格列美脲2～4 mg早晨口服的治疗方法可使单纯口服降糖药控制不佳的2型糖尿病患者得到良好的血糖控制。两种方法的疗效大致相同，但甘精胰岛素治疗低血糖事件发生率低,故更具选择优势。 【关键词】 糖尿病，2型；甘精胰岛素; 低血糖 Comparison of Therapeutic Effects Between Glargine and Novolin N Combined Respectively with Glimepiride in Type 2 Diabetes Mellitus HAN Chun-sheng, Department of Endocrinology, Third Affiliated Hospital of Qiqihaer Medical College, Qiqihaer, 161000, China 【Abstract】 Objective To study comparison of therapeutic effects between glargine and Novolin N combined respectively with glimepiride in type 2 diabetes mellitus.Methods Fourty two patients with type 2 diabetes in plasma glucose poorly controlled（HBA1c7.0 %）with treatment of oral hypoglycemic agents at least three months, free choice by oneself，injected glargine or Novolin N before sleep combined with treatment of glimepiride 2~4 mg in the morning once every day for 16 weeks. The changes of FPG和HbA1c levels before and after the treatment were compared between glargine group and Novolin N group, and differences between the two groups were evaluated.Results By 16 weeks, the mean value of HbA1c in glargine group and Novolin N group decreased respectively 1．9±0．8% and 1．8±0．9%(P=0．6864), the mean value of FPG decreased respectively 3．5±1．4 mmol/L和3．1±1．5 mmol/(P=0．4373), there were no significant difference at efficacy between the two groups. The numbers of symptomatic hypoglycaemia (6/14vs14/6; P=0．0105) and incidence of hypoglycemia at night(6vs31;P=0．0040) decreased significantly in glargine group compared with Novolin N group. Conclusion The present study showed that patients