摘要
目的探讨格列美脲联合长效胰岛素治疗2型糖尿病患者临床效果及安全性。方法选取2020-01-01-2022-12-30枣庄市峄城区人民医院收治的200例2型糖尿病患者为研究对象,依据随机数字表法分为观察组和对照组,各100例。对照组给予格列美脲联合精蛋白生物合成人胰岛素注射液(商品名:预混50R)治疗,观察组给予格列美脲联合长效胰岛素治疗。分别于治疗前及治疗后不同时段检测患者血糖水平[空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbAlc)]、体质量指数(BMI)、胰岛功能[空腹胰岛素(Fins)、餐后2 h胰岛素(2 Pins)、胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)]、血脂指标[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)],对比治疗效果及不良反应发生情况。结果治疗后,观察组FBG、2 h PBG、HbAlc、BMI分别为(5.53±0.42)mmol/L、(8.04±0.58)mmol/L、(5.85±0.62)%、(24.21±1.02)kg/m^(2),对照组分别为(6.40±0.58)mmol/L、(8.72±0.62)mmol/L、(6.73±0.51)%、(25.03±1.12)kg/m^(2),2组血糖指标及BMI均改善,且观察组优于对照组,F值分别为57.954、48.963、75.872和37.476,均P<0.001;Fins、2 Pins、HOMA-β、HOMA-IR分别为(5.23±0.70)mU/L、(19.61±2.51)mU/L、52.64±4.50、1.23±0.51,对照组分别为(4.32±0.68)mU/L、(12.33±2.57)mU/L、37.26±5.49、1.53±0.53,2组Fins、2 Pins、HOMA-β均提高,HOMA-IR均降低,观察组改善幅度大于对照组,F值分别为63.578、165.730、432.160和48.894,均P<0.001。治疗后,观察组TC、TG、LDL-C和HDL-C分别为(2.83±0.42)、(3.03±0.37)、(1.42±0.25)和(1.69±0.42)mmol/L,对照组分别为(3.42±0.46)、(3.61±0.29)、(2.26±0.31)和(1.61±0.37)mmol/L,2组TC、TG、LDL-C均降低,且观察组降低更明显,F值分别为124.286、74.246和126.830,均P<0.001;HDL-C均升高,观察组略高于对照组,但差异无统计学意义,F=1.583,P=0.547。观察组总有效率为94.00%,高于对照组的83.00%,χ^(2)=5.945,P=0.015。观察组不良反应发生率为3.00%,低于对照组的15.00%,χ^(2)=8.791,P=0.003。结论格列美脲联合长效胰岛素能够提升2型糖尿病患者血糖控制效果,改善胰岛素功能及血脂水平,疗效确切且能减少不良反应的发生。
Objective To observe the clinical efficacy and safety of glimepiride combined with long-acting insulin in patients with type 2 diabetes.Methods Totally 200 patients with type 2 diabetes who were admitted to Yicheng District People's Hospital of Zaozhuang City from January 1,2020 to December 30,2022 were selected as the research objects,and were divided into the observation group and the control group according to the random number table method,with 1oo cases in each group.The control group was treated with glimepiride combined with protamine biosynthetic human insulin injection(trade name:premixed 5oR),while the observation group was treated with glimepiride combined with long-acting insulin.Blood glucose levels[fasting blood glucose(FBG),2-hour postprandial blood glucose(2 h PBG),glycated hemoglobin(HbAlc)],body mass index(BMI),pancreatic function[fasting insulin(Fins),2-hour postprandial insulin(2 Pins),and pancreatic isletsβCell function Index(HOMA-β),insulin resistance index(HOMA-IR)],blood lipid indicators[total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)] were measured before and at different times after treatment.The treatment effect and incidence of adverse reactions were compared between the two groups.Results After treatment,the FBG,2 h PBG,HbAlc,and BMI of the observation group were(5.53±0.42)mmol/L,(8.04±0.58)mmol/L,(5.85±0.62)%,and(24.21±1.02)kg/m^(2),respectively.These indicators in the control group were(6.40±0.58)mmol/L,(8.72±0.62)mmol/L,(6.73±0.51)%,and(25.03±1.12)kg/m^(2),respectively.The blood glucose indicators and BMI of both groups improved,and the observation group was superior to the control group,with F-values of 57.954,48.963,75.872,and 37.476,respectively.All P<0.001;Fins,2Pins,HOMA-β,HOMA-IRwere(5.23±0.70)mU/L,(19.61±2.51)mU/L,52.64±4.50,and1.23±0.51,respectively in the observation group.Those in the control group were(4.32±0.68)mU/L,(12.33±2.57)mU/L,37.26±5.49,and 1.53±0.53,respectively.Fins,2 Pins,HOMA-βin both groups increased,while HOMA-IR decreased,and the improvement in the observation group was greater than that in the control group.The F-values were 63.578,165.730,432.160,and 48.894,respectively,with all P<0.001.After treatment,the TC,TG,LDL-C,and HDL-C levels in the observation group were(2.83±0.42),(3.03±0.37),(1.42±0.25)and(1.69±0.42)mmol/L,respectively.The control group was(3.42±0.46),(3.61±0.29),(2.26±0.31)and(1.61±0.37)mmol/L,respectively.TC,TG,and LDL-C levels in both groups decreased,and the observation group showed a more significant decrease,with F-values of 124.286,74.246,and 126.830,respectively,P<0.001;HDL-C levels all increased,with the observation group slightly higher than the control group,but the difference was not statistically significant,F=1.583,P=0.547.The total effective rate of the observation group was 94.00%,higher than 83.00%of the control group,with χ^(2)=5.945 and P=0.015.The incidence of adverse reactions in the observation group was 3.00%,lower than the control group's 15.00%,χ^(2)=8.791,P=0.0o3.Conclusion Glimepiride combined with long-acting insulin is beneficial to improve the effect of blood glucose control,insulin function and blood lipid level in patients with type 2 diabetes.The efficacy is reliable,and can reduce the occurrence of hypoglycemia and other adverse reactions.
作者
李欣
李季
常晓侠
LI Xin;LI Ji;CHANG Xiaoxia(Department of Endocrine,Yicheng District People's Hospital of Zaozhuang City,Zaozhuang,Shandong 277300,China;Department of Cardiovascular Medicine,Mouping District Traditional Chinese Medicine Hospital of Yantai City,Mouping,Shandong 264100,China)
出处
《社区医学杂志》
CAS
2023年第24期1295-1300,共6页
Journal Of Community Medicine
关键词
2型糖尿病
格列美脲
长效胰岛素
胰岛素功能
血脂
低血糖
type 2 diabetes
glimepiride
long acting insulin
insulin function
blood lipids
hypoglycemia
作者简介
第一作者:李欣,男,山东枣庄人,主治医师,主要从事内科内分泌相关疾病的临床研究工作。E-mail:lx13370996650@163.com;通信作者:常晓侠,女,山东烟台人,硕士,主治医师,主要从事内科心内科相关疾病的临床研究工作。E-mail:446398188@qq.com。
