那格列奈联合甘精胰岛素治疗磺脲类继发性失效2型糖尿病的疗效及安全性(1)
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[摘要] 目的:探讨磺脲类继发性失效2型糖尿病加用甘精胰岛素或改用那格列奈联合甘精胰岛素治疗的疗效及安全性。方法:将磺脲类继发性失效的2型糖尿病患者分为两组,试验组停用磺脲类药物,改用那格列奈联合甘精胰岛素治疗;对照组在继续原磺脲类药物治疗的同时,加用甘精胰岛素治疗。疗程均为3个月,分别测定治疗前后空腹血糖、餐后2 h血糖、糖化血红蛋白,血C肽等,并记录不良反应事件的发生率。结果:①试验组及对照组治疗后空腹血糖、餐后2 h血糖及糖化血红蛋白均明显下降,各时段C肽水平明显升高,与治疗前比较,差异有统计学意义(P<0.05或P<0.01)。②空腹血糖下降、糖化血红蛋白下降、空腹C肽上升、30 min C肽上升、120 min C肽上升在两组间比较,差异无统计学意义(P>0.05)。③试验组餐后2 h血糖下降比较明显,与对照组比较,差异有统计学意义(P<0.05)。④试验组C肽峰值出现在餐后1 h,高于对照组,两者比较,差异有统计学意义(P<0.05);对照组C肽峰值出现在餐后3 h,高于试验组,两组比较,差异有统计学意义(P<0.05)。⑤试验组低血糖发生率较对照组低,组间比较,差异有统计学意义(P<0.05)。结论:在磺脲类失效患者中,改用那格列奈联合甘精胰岛素治疗降糖效果好,可恢复胰岛素第一时相分泌。餐后2 h血糖控制优于继续使用磺脲类药物加甘精胰岛素组患者,且低血糖发生率更低,安全性更好。
[关键词] 2型糖尿病;那格列奈;甘精胰岛素;磺脲类;糖化血红蛋白
[中图分类号] R587.1[文献标识码]A [文章编号]1673-7210(2010)06(c)-018-03
Therapeutic effect and safety of Nateglinide combined with Insulin Glargine in the treatment of type 2 diabetes patients with secondary sulphanyluteas drugs failure
CHEN Jiangping1, LIU Xiujuan2
(1.Department of Endocrinology, Jiangmen Central Hospital of Guangdong Province & Jiangmen Hospital Affiliated to Sun Yat-sen University, Jiangmen529030, China; 2.Department of Science and Education, Jiangmen Central Hospital of Guangdong Province & Jiangmen Hospital Affiliated to Sun Yat-sen University, Jiangmen529030, China)
[Abstract] Objective: To investigate the efficacy and safety of Nateglinide combined with Insulin Glargine in the treatment of type 2 diabetes patients with secondary sulfonylureas failure. Methods: Type 2 diabetes patients with secondary sulfonylureas failure were divided into two groups. The trial group was treated by Nateglinide with Insulin Glargine Injection. The control group was shifted to sulphanylureas drugs plus Glargine. Both groups were under treatment for three months with determining the fasting blood glucose (FBG), 2 hour postprandial blood (2 h PG), glycosylated hemoglobin (HbA1c) and C-peptide before and after the treatment as well as adverse reactions ......
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