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目的:观察地特胰岛素联合格列美脲治疗2型糖尿病(T2DM)的有效性、安全性。方法:68例口服降糖药血糖控制不佳的T2DM患者,停用原口服降糖药,按1∶1随机分为格列美脲联合地特胰岛素组(Det组)和甘精胰岛素组(Gla组),治疗24周。结果:24周后,2组HbA1c、FBG、2hBG均较基线下降,空腹及餐后C肽则较基线明显升高,但组间差异无统计学意义(P>0.05)。2组低血糖发生率相同,均为5.9%。Det组胰岛素用量较Gla组增多,差异无统计学意义(P>0.05)。Det组体重增加明显低于Gla组(P<0.01)。结论:口服降糖药血糖控制不佳的T2DM患者,采用地特胰岛素或甘精胰岛素联合格列美脲均可有效控制血糖且不增加低血糖风险,前者在减少体重增加方面更有优势。
Objective: To observe the efficacy and safety of insulin detemir plus glimepiride in the treatment of type 2 diabetes mellitus (T2DM). Methods: Sixty-eight patients with T2DM with poorly controlled blood glucose control were randomized to receive either dexamethasone plus dextromethorphan (Det) or insulin glargine Gla group) for 24 weeks. Results: After 24 weeks, the HbA1c, FBG and 2hBG in two groups decreased from baseline, and the fasting and postprandial C-peptide levels increased significantly from baseline, but there was no significant difference between the two groups (P> 0.05). The incidence of hypoglycemia in the two groups were the same, both 5.9%. The amount of insulin in Det group increased compared with Gla group, with no significant difference (P> 0.05). Body weight gain in the Det group was significantly lower than that in the Gla group (P <0.01). Conclusion: T2DM patients with poor glycemic control of oral hypoglycemic agents, insulin detemir or insulin glargine combined with glimepiride can effectively control blood sugar without increasing the risk of hypoglycemia, the former is more advantageous in reducing weight gain.