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选择160例T2DM患者分为4组;A组磺脲类联合中效胰岛素(NPH);B组:拜唐苹联合NPH;C组:二甲双胍联合NPH;D组:胰岛素强化治疗三餐前注射常规胰岛素,睡前注射NPH。比较其治疗前、后空腹及餐后2h血糖、糖化血红蛋白(HbA1c)的变化,分析治疗后四组患者胰岛素用量、体重变化及低血糖的发生率。结果①四组FPG和PPG以及HbA1c均明显降低,(P<0.01);以D组下降最明显。②胰岛素用量:与D组比较,其他三组用量相对较少(P<0.01)。③B、C组低血糖发生率较低,有显著性差异(分别为P<0.01、P<0.05);A、D组低血糖发生率相对较高。④A、D组体重增加明显(P<0.05),B组轻度增加,C组无明显增加。⑤与其他3组比较,D组血糖达标平均时间最短(P<0.01)。结论T2DM患者口服降糖药物失效后,及早采用联合NPH胰岛素治疗,与胰岛素强化治疗效果基本相同,均能显著降低血糖水平,减少胰岛素用量,并且减少低血糖的发生率,提高病人对胰岛素的依从性。
A total of 160 T2DM patients were divided into four groups: Group A: sulfonylureas combined with moderate-effect insulin (NPH); Group B: methotrexate combined with NPH; Group C: metformin combined with NPH; Group D: insulin pre- Insulin, NPH at bedtime. The fasting and postprandial blood glucose and HbA1c levels at 2h were compared before and after treatment. The insulin dosage, weight change and the incidence of hypoglycemia in the four groups were analyzed. Results ① The four groups of FPG, PPG and HbA1c were significantly decreased (P <0.01), and the most obvious decrease was in group D. ② insulin dosage: compared with the D group, the other three groups were relatively less dosage (P <0.01). ③ The incidence of hypoglycemia in groups B and C was lower, with significant difference (P <0.01 and P <0.05, respectively). The incidence of hypoglycemia in groups A and D was relatively high. ④A, D group weight increased significantly (P <0.05), B group increased slightly, C group had no significant increase. ⑤ Compared with the other three groups, the average blood glucose of group D reached the shortest average (P <0.01). Conclusion T2DM patients with oral hypoglycemic drugs, the early combination of NPH insulin treatment, and insulin treatment is basically the same effect, can significantly lower blood glucose levels, reduce insulin dosage, and reduce the incidence of hypoglycemia and improve patient compliance with insulin Sex.