西格列汀或格列美脲联合地特胰岛素治疗2型糖尿病临床研究.docVIP

西格列汀或格列美脲联合地特胰岛素治疗2型糖尿病临床研究 　　DOI：10.16658/j.cnki.1672-4062.2017.05.090 　　[摘要] 目的 比较西格列汀联合地特胰岛素与格列美脲联合地特胰岛素治疗T2DM的疗效。 方法 将80例口服降糖药OAD血糖控制不佳的 T2DM患者随机分为西格列汀联合地特胰岛素组（观察组 ）和格列美脲联合地特胰岛素组 （对照组 ），治疗12周，观察FPG、2 hPG、HbA1c、BMI等指标及低血糖发生情况、胰岛素用量。 结果 治疗后两组FPG、2 hPG、 HbA1c均较治疗前下降（P0.05），但观察组胰岛素用量比对照组减少了10.4%，同时低血糖发生率低，BMI得到控制。 结论 西格列汀联合地特胰岛素治疗在有效控制血糖和体重同时，减少低血糖事件，同等HbA1c达标情况下，所用的胰岛素剂量更少。 　　[关键词] 西格列汀；地特胰岛素；格列美脲2型糖尿病 　　[中图分类号] R969 [文献标识码] A [文章编号] 1672-4062（2017）03（a）-0090-03 　　Clinical Research on Sitagliptin or Glimepiride Combined with Insulin Detemir in Treatment of Type 2 Diabetes 　　ZHOU Jia-li， ZHANG Jian-wei， CHEN Xiao-lei 　　Department of Endocrinology， Kunming First People’s Hospital， Kunming， Yunnan Province， 650011 China 　　[Abstract] Objective To compare the curative effect of sitagliptin or glimepiride combined with Insulin detemir in treatment of type 2 diabetes. Methods 80 cases of T2DM patients taking the hypoglycemic orally but with bad blood glucose control effect were randomly divided into two groups， the observation group adopted the sitagliptin and insulin detemir， while the control group adopted the glimepiride combined with insulin detemir， after 12-week treatment， the FPG， 2hPG， HbA1c， BMI and occurrence of low blood glucose and insulin dose of the two groups were observed. Results The FPG， 2hPG， HbA1c of the two groups decreased compared with those before treatment（P0.05）， but the insulin dose in the observation group decreased by 10.4% compared with that in the control group， at the same time， the incidence rate of low blood glucose was low and BMI was controlled. Conclusion Sitagliptin and insulin detemir treatment can effectively control the blood glucose and weight and reduce the low blood glucose events， which can reach the same HbA1c standard-reaching rate with less insulin dose. 　　[Key words] Sitagliptin； Insulin detemir； Glimepiride； Type 2 diabetes 　　2型糖尿病（type 2 diabetes mellitus，T2DM）?l病的关键机制---胰岛素分泌和作用缺陷，胰岛B细胞功能失代偿的结局就是血糖进行性升高。理想的治疗方