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目的对HbA1c>9%的新诊断的T2DM患者进行地特胰岛素(Det)联合二甲双胍的短期强化治疗,探讨Det作为基础胰岛素的疗效。方法 40例新诊断的T2DM患者随机分为治疗组与对照组,每组20例,治疗组予以Det联合二甲双胍治疗,对照组予以格列美脲及二甲双胍治疗,疗程12周,对其在治疗前后血糖控制情况及胰岛β细胞功能进行自身及组间比较。结果治疗后两组FBG、2hBG及标准餐血糖曲线下面积(AUC-G)、HbA1c、HOMA-IR均显著下降,HOMA-β升高(P均<0.01)。Det组FBG、2hBG、AUC-G及HOMA-β治疗前后的差值高于对照组,差异有统计学意义(P<0.05)。Det组在降低血糖的同时更好地改善了基础胰岛β细胞功能。结论 Det作为基础胰岛素联合二甲双胍治疗为新诊断时HbA1c>9%的T2DM患者提供了一种简便、有效、安全的门诊强化治疗方案。
Objective To investigate the short-term intensive treatment of Det and metformin in newly diagnosed T2DM patients with HbA1c> 9% and explore the efficacy of Det as a basal insulin. Methods Forty patients with newly diagnosed T2DM were randomly divided into treatment group and control group, with 20 cases in each group. The treatment group was treated with Det combined with metformin, the control group was treated with glimepiride and metformin for 12 weeks. Before and after treatment Glycemic control and pancreatic β-cell function for self and between groups. Results After treatment, the areas under the curve of FBG, 2hBG and standard blood glucose (AUC-G), HbA1c and HOMA-IR of both groups were significantly decreased and HOMA-β was increased (all P <0.01). The difference of FBG, 2hBG, AUC-G and HOMA-β before and after treatment in Det group was higher than that in control group, with significant difference (P <0.05). The Det group improved basal pancreatic beta-cell function while lowering blood glucose. Conclusion Det as a basal insulin combined with metformin provides a simple, effective and safe outpatient intensive care regimen for newly diagnosed T2DM patients with HbA1c> 9%.