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目的观察那格列奈或联用二甲双胍对初诊2型糖尿病血糖波动性的作用。方法 60例初诊2型糖尿病患者分为单纯那格列奈治疗组(A组,28例)、那格列奈联合二甲双胍治疗组(B组,32例)。入院后检测患者体重指数(BMI)、糖化血红蛋白(HbA1c)等指标;同时采用动态血糖监测系统(CGMS)进行连续72 h血糖监测,以平均血糖标准差(SDBG)、日内平均血糖波动幅度(MAGE)、日间血糖平均绝对差(MODD)反映血糖波动性。治疗3个月后随访复查上述指标。结果治疗前,B组BMI高于A组(P<0.05),两组HbA1c、SDBG、MAGE、MODD差异无统计学意义(P>0.05);治疗后,B组BMI较治疗前降低(P<0.05),两组HbA1c、SDBG、MAGE、MODD均分别较治疗前明显改善(P<0.05)。结论初诊2型糖尿病患者单用那格列奈,或BMI较高患者那格列奈联用二甲双胍治疗,不仅能有效降低血糖,而且能改善血糖波动。
Objective To observe the effect of nateglinide or metformin on the blood glucose fluctuation in newly diagnosed type 2 diabetic patients. Methods Sixty newly diagnosed type 2 diabetic patients were divided into nateglinide treatment group (group A, n = 28) and nateglinide combined with metformin treatment (group B, n = 32). The body mass index (BMI), HbA1c and other indexes were measured after admission. Meanwhile, continuous 72-hour blood glucose monitoring was performed by dynamic blood glucose monitoring system (CGMS). The mean standard deviation of blood glucose (SDBG), the average daily blood glucose fluctuation ), Mean absolute difference in blood glucose during the day (MODD) reflect the blood glucose fluctuations. 3 months after treatment, follow-up review of the above indicators. Results Before treatment, the BMI in group B was higher than that in group A (P <0.05). There was no significant difference in HbA1c, SDBG, MAGE and MODD between the two groups (P> 0.05) 0.05). HbA1c, SDBG, MAGE and MODD were significantly improved in both groups (P <0.05). Conclusions Patients with newly diagnosed type 2 diabetes treated with nateglinide alone or with higher BMI may be treated with metformin, which not only reduces blood glucose, but also improves blood glucose.