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目的探讨二甲双胍联合甘精胰岛素治疗初诊2型糖尿病肥胖的临床效果。方法 64例初诊2型糖尿病肥胖患者,按照随机数表法分为对照组和观察组,各32例。对照组单纯使用甘精胰岛素治疗,观察组使用二甲双胍联合甘精胰岛素治疗,比较两组治疗效果。结果治疗后观察组患者体质量指数(BMI)为(24.08±5.07)kg/m2,空腹血糖(FPG)为(5.83±1.16)mmol/L,餐后2 h血糖(2 h PG)为(8.12±2.42)mmol/L,糖化血红蛋白(Hb A1c)为(6.01±1.69)%;对照组患者BMI为(25.94±6.43)kg/m~2;FPG为(7.92±2.04)mmol/L,2 h PG为(9.94±2.53)mmol/L,Hb A1c为(7.95±2.11)%;治疗后,两组患者BMI、血糖水平较治疗前改善,且观察组改善程度明显优于对照组(P<0.05)。治疗后观察组血清总胆固醇(TC)为(4.06±0.98)mmol/L,甘油三酯(TG)为(1.73±0.55)mmol/L,高密度脂蛋白胆固醇(HDL-C)为(1.74±0.52)mmol/L,低密度脂蛋白胆固醇(LDL-C)为(3.34±1.06)mmol/L;对照组患者TC为(5.07±1.16)mmol/L,TG为(2.42±0.29)mmol/L,HDL-C为(1.40±0.33)mmol/L,LDL-C为(3.89±1.24)mmol/L;治疗后,两组血脂水平较治疗前有所改善,观察组改善程度明显优于对照组(P<0.05)。观察组胰岛素日用量为(14.07±2.34)IU,明显低于对照组(18.48±4.09)IU,差异具有统计学意义(P<0.05)。治疗过程中,观察组低血糖发生率为15.63%,对照组低血糖发生率为43.75%,两组患者低血糖发生率比较差异具有统计学意义(P<0.05)。结论应用二甲双胍联合甘精胰岛素治疗初诊2型糖尿病肥胖,可有效控制患者血糖、血脂水平,减少低血糖事件的发生。
Objective To investigate the clinical efficacy of metformin combined with insulin glargine in the treatment of newly diagnosed type 2 diabetic obesity. Methods Sixty-four newly diagnosed obese patients with type 2 diabetes mellitus were divided into control group and observation group according to the random number table method, with 32 cases in each group. The control group was treated with insulin glargine only. The observation group was treated with metformin and insulin glargine. The therapeutic effect was compared between the two groups. Results After treatment, the body mass index (BMI), fasting blood glucose (FPG), and postprandial blood glucose (2 h PG) of observation group were (24.08 ± 5.07) kg / ± 2.42 mmol / L, and Hb A1c was (6.01 ± 1.69)% in the control group. The BMI in the control group was (25.94 ± 6.43) kg / m 2 and the FPG was (7.92 ± 2.04) mmol / L for 2 h PG was (9.94 ± 2.53) mmol / L and Hb A1c was (7.95 ± 2.11)% respectively. After treatment, the BMI and blood glucose level improved in both groups and the improvement in observation group was better than that in control group (P <0.05 ). After treatment, the total cholesterol (TC) in the observation group was (4.06 ± 0.98) mmol / L, the triglyceride (TG) was 1.73 ± 0.55 mmol / L and the HDL-C was 1.74 ± 0.56 mmol / L LDL-C and 3.34 ± 1.06 mmol / L LDL-C, respectively. The TC of the control group was (5.07 ± 1.16) mmol / L and the TG was (2.42 ± 0.29) mmol / L (1.40 ± 0.33) mmol / L for HDL-C and (3.89 ± 1.24) mmol / L for LDL-C. After treatment, the level of blood lipid in the two groups improved compared with that before treatment, and the improvement in the observation group was significantly better than that in the control group (P <0.05). The daily dosage of insulin in the observation group was (14.07 ± 2.34) IU, which was significantly lower than that of the control group (18.48 ± 4.09) IU, the difference was statistically significant (P <0.05). During the course of treatment, the incidence of hypoglycemia was 15.63% in the observation group and 43.75% in the control group. There was significant difference between the two groups in the incidence of hypoglycemia (P <0.05). Conclusion Metformin combined with insulin glargine for the treatment of newly diagnosed type 2 diabetes obesity can effectively control the blood glucose and blood lipid levels and reduce the incidence of hypoglycemic events.