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目的研究采用胰岛素联合口服降糖药控制血糖的2型糖尿病患者的临床特征。方法回顾分析478例因血糖控制不佳住院而在出院时空腹血糖均在7.0mmol/L以下的内分泌科2型糖尿病患者,根据是否联合二甲双胍分为2组,即胰岛素组、胰岛素加二甲双胍组,再按胰岛素剂量大小分为A(<60U)、B(≥60U)2个亚组,比较各组年龄、病程、体质量指数(BMI)、腰臀比(WHR)、血压、血脂、糖化血红蛋白(HbA1C)、糖化血清蛋白(Gsp)、口服葡萄糖耐量试验等,用Homa-胰岛素抵抗(IR)评估胰岛素抵抗,用Homa-β、DI评估胰岛B细胞功能。结果与胰岛素组相比,胰岛素加二甲双胍组WHR、HbA1C、Gsp较高(P<0.05),而胰岛素用量却较低(P<0.05),Homa-IR指数较高(P<0.05),而DI指数较低(P<0.05)。胰岛素加二甲双胍组A、B亚组相比,B组年龄较A组小(P<0.05),WHR、甘油三酯较高(P<0.05),高密度脂蛋白胆固醇较低(P<0.05)。结论胰岛素联合二甲双胍控制血糖可以改善胰岛素敏感性,有效控制血糖,减少外源胰岛素用量。
Objective To study the clinical features of type 2 diabetes mellitus using insulin combined with oral hypoglycemic agents to control blood glucose. Methods A retrospective analysis of 478 cases of type 2 diabetes in endocrinology with fasting blood glucose below 7.0 mmol / L after discharge due to poor blood glucose control were divided into 2 groups according to whether metformin, namely insulin group, insulin plus metformin group, Then according to the dose of insulin, the patients were divided into two subgroups: A (<60U) and B (≥60U). The changes of age, course of disease, body mass index (BMI), WHR, blood pressure, (HbA1C), glycosylated serum protein (Gsp), oral glucose tolerance test, etc. Insulin resistance was evaluated by Homa-insulin resistance (IR), and islet B cell function was evaluated by Homa-β, DI. Results Compared with the insulin group, the WHR, HbA1C and Gsp in insulin plus metformin group were higher (P <0.05), while the insulin dosage was lower (P <0.05) and Homa-IR index was higher (P <0.05) The index was lower (P <0.05). (P <0.05), WHR, triglyceride (P <0.05), and high density lipoprotein cholesterol (P <0.05) in group B compared with those in group A and B with insulin and metformin. . Conclusion Insulin combined with metformin to control blood sugar can improve insulin sensitivity, effectively control blood sugar and reduce the amount of exogenous insulin.