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目的探讨甘精胰岛素与口服降糖药联用控制空腹及餐后高血糖的疗效。方法将136例单用口服降糖药血糖控制不理想的T2DM患者随机分为A、B两组。A组采用国产甘精胰岛素(长秀霖),B组采用进口甘精胰岛素(来得时),两组在用甘精胰岛素的基础上,均分别与二甲双胍和瑞格列奈联用,观察治疗前后FPG、2hPG及HbA_1c水平和低血糖的发生率。结果治疗后两周时FPG、2hPG及HbA_1c水平与治疗前相比均明显下降,但仍未达标。两组患者在甘精胰岛素和二甲双胍治疗的基础上加用瑞格列奈,治疗后4周时FPG及2hPG水平均已达标,HbA_1c水平于治疗2个月时达标。两组治疗后各项指标与治疗前相比均明显下降(P均<0.01),两组临床疗效无统计学差异,低血糖发生率分别为4.2%和4.6%,相比无统计学差异(P>0.05)。结论两种甘精胰岛素分别与二甲双胍和瑞格列奈联用,能较好控制FPG、2hPG及HbA_1c水平,低血糖发生率均较低,临床疗效相近。因此,甘精胰岛素与二甲双胍和瑞格列奈联用是控制FPG、2hPG及HbA_1c水平的安全有效的治疗方案。
Objective To investigate the effect of insulin glargine combined with oral hypoglycemic agents on fasting and postprandial hyperglycemia. Methods One hundred and sixty-six patients with T2DM who were not controlled by oral hypoglycemic agents were randomly divided into A and B groups. A group using domestic glargine (Chang Xiulin), B group using imported insulin glargine (when obtained), two groups in the use of insulin glargine, were respectively metformin and repaglinide, observation and treatment Before and after FPG, 2hPG and HbA_1c levels and the incidence of hypoglycemia. Results The levels of FPG, 2hPG and HbA_1c in two weeks after treatment were significantly lower than those before treatment, but still not reached the standard. Two groups of patients were treated with repaglinide on the basis of insulin glargine and metformin. The levels of FPG and 2hPG were all reached at 4 weeks after treatment, and the level of HbA_1c reached the standard at 2 months after treatment. After treatment, the indexes of both groups were significantly lower than those before treatment (all P <0.01). There was no significant difference in the clinical efficacy between the two groups. The incidence of hypoglycemia was 4.2% and 4.6% respectively, with no significant difference P> 0.05). Conclusion Both insulin glargine combined with metformin and repaglinide can better control the levels of FPG, 2hPG and HbA 1c, the incidence of hypoglycemia is lower, and the clinical efficacy is similar. Therefore, the combination of insulin glargine and metformin and repaglinide is a safe and effective treatment for FPG, 2hPG and HbA_1c levels.