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目的比较甘精胰岛素联合口服降糖药物与多次皮下胰岛素注射两种方案的血糖控制情况和对胰岛β细胞功能的影响。方法108例初诊的2型糖尿病患者随机分为甘精胰岛素联合口服降糖药物组(A组,n=52)和多次胰岛素皮下注射组(B组,n=56),治疗4周。测定每组治疗前后FPG、2hPG、糖化血红蛋白(HBA1c)、体重指数(BMI)、葡萄糖耐量及胰岛素释放试验,计算胰岛β细胞功能指数(Homa-β)、胰岛素抵抗指数(Homa-IR)和早相胰岛素分泌指数(△I30/△G30)。结果两组治疗后FBG、2hPG、HBA1c均较治疗前有明显下降(P<0.01);Homa-β、△I30/△G30较治疗前明显增加,HomaIR明显下降,差异均有统计学意义(P<0.01)。两组比较,除血糖达标时间及胰岛素用量的差异有统计学意义(P<0.05,P<0.01)外,同期的FPG、2hPG、HBA1c、BMI、Homa-β、Homa-IR及△I30/△G30差异均无统计学意义(P>0.05)。结论甘精胰岛素联合口服降糖药物治疗,可使初诊的2型糖尿病患者的血糖获得理想控制,且改善β细胞功能,降低胰岛素抵抗,低血糖发生率低,使用方便、易行,患者依从性好。
Objective To compare the effects of insulin glargine plus oral hypoglycemic agents and multiple subcutaneous insulin injections on the blood glucose control and on the function of islet β cells. Methods 108 cases of newly diagnosed type 2 diabetic patients were randomly divided into glargine and oral hypoglycemic group (A group, n = 52) and multiple subcutaneous injection of insulin (group B, n = 56) for 4 weeks. The levels of FPG, 2hPG, HBA1c, BMI, glucose tolerance and insulin release were measured before and after treatment. Homa-β, Homa-IR, Phase insulin secretion index (△ I30 / △ G30). Results The levels of FBG, 2hPG and HBA1c in both groups were significantly lower than those before treatment (P <0.01). The levels of Homa-β, △ I30 / △ G30 were significantly increased and HomaIR was significantly decreased in both groups (P <0.01). The levels of FPG, 2hPG, HBA1c, BMI, Homa-β, Homa-IR and △ I30 / △ in the same period were significantly higher than those in the control group (P <0.05, P <0.01) G30 had no significant difference (P> 0.05). Conclusion Glargine and oral hypoglycemic drug treatment can make the newly diagnosed type 2 diabetic patients achieve optimal control of blood glucose, and improve β-cell function, reduce insulin resistance, low incidence of hypoglycemia, easy to use, easy to use, patient compliance it is good.