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目的:观察甘精胰岛素联合那格列奈治疗新诊断2型糖尿病(T2DM)的疗效及安全性。方法:入选新诊断T2DM患者80例(年龄≤60岁),随机分为3组:A组22例采用≥2种口服降糖药联合治疗;B组28例采用甘精胰岛素每日1次联合那格列奈120或240 mg口服;C组30例采用预混胰岛素30R或50R餐前30 min皮下注射,bid。治疗12周后观察3组患者血糖达标的时间,空腹血糖(FBG)、餐后2 h血糖(2HBG)、糖化血红蛋白(HbA1c)、体质量指数(BMI)等的变化及低血糖频次。结果:在饮食及及运动达标的前提下3组FBG、2HBG达到理想水平的时间分别为8.2 d、7.1 d及6.5 d,FBG、2HBG、HbA1c较治疗前明显下降(P<0.05),其中B、C两组HbA1c下降幅度显著超过A组(P<0.05);3组因FBG及2HBG未达理想水平退出观察的病例各为8例、4例、7例,严重低血糖发生的例数分别为3例、3例、6例。结论:甘精胰岛素联合那格列奈对新诊断的T2DM在取得满意治疗效果的同时,具有达标率高、低血糖发生率低、安全性好的优势。
Objective: To observe the efficacy and safety of insulin glargine combined with nateglinide in the treatment of newly diagnosed type 2 diabetes mellitus (T2DM). Methods: Eighty newly diagnosed T2DM patients (≤60 years of age) were enrolled in this study. They were randomly divided into 3 groups: 22 cases in group A were treated with ≥2 oral hypoglycemic agents; 28 cases in group B were treated with insulin glargine once daily Nateglinide 120 or 240 mg orally; Group C 30 patients with premixed insulin 30R or 50R subcutaneous injection of 30 min before meals, bid. After 12 weeks of treatment, the change of fasting blood glucose, fasting blood glucose (FBG), 2h postprandial blood glucose (2HBG), HbA1c, body mass index (BMI) and the frequency of hypoglycemia were observed in the three groups. Results: The FBG, 2HBG and HbA1c levels in FBG, 2HBG and HbA1c group were significantly lower than those before treatment (8.2 days, 7.1 days and 6.5 days, respectively) under the premise of diet and exercise. , C group HbA1c decreased significantly more than A group (P <0.05); 3 groups of FBG and 2HBG less than the ideal level out of the observed cases were 8 cases, 4 cases, 7 cases, the incidence of severe hypoglycemia cases were 3 cases, 3 cases, 6 cases. Conclusion: Glargine combined with nateglinide has the advantage of achieving satisfactory therapeutic effect on newly diagnosed T2DM patients with high compliance rate, low incidence of hypoglycemia and good safety.