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目的探讨甘精胰岛素联合瑞格列奈治疗2型糖尿病(T2DM)的疗效及安全性。方法选择初诊T2DM患者39例,给予甘精胰岛素每日1次皮下注射控制空腹血糖,同时3餐前服用瑞格列奈控制餐后血糖。治疗3个月后测空腹血糖(FPG)、餐后2h血糖(PG2h)、糖化血红蛋白(HbA1c)以及空腹胰岛素、C肽及餐后2h胰岛素、C肽。结果治疗前、治疗后FPG分别为(12.86±2.80)、(5.82±0.43)mmol/L,PG2h分别为(18.21±4.67)、(7.28±2.47)mmol/L,治疗前后FPG及PG2h水平比较,差异均有统计学意义(P均<0.01);HbA1c分别为(7.81±1.22)%、(6.42±0.81)%(P<0.05)。治疗后胰岛素及C肽测定显示胰岛功能明显改善。结论甘精胰岛素联合瑞格列奈治疗可模拟人生理胰岛素分泌,有效控制血糖,改善β细胞功能,且使用安全。
Objective To investigate the efficacy and safety of insulin glargine plus repaglinide in type 2 diabetes mellitus (T2DM). Methods Thirty-nine newly diagnosed T2DM patients were given subcutaneous injection of insulin glargine 1 times a day to control fasting blood glucose. Meanwhile, repaglinide was administered before 3 meals to control postprandial blood glucose. Fasting blood glucose (FPG), postprandial blood glucose (PG2h), HbA1c, fasting insulin, C-peptide and 2-hour postprandial insulin and C-peptide were measured after 3 months of treatment. Results Before treatment, the levels of FPG were (12.86 ± 2.80) and (5.82 ± 0.43) mmol / L and PG2h were (18.21 ± 4.67) and (7.28 ± 2.47) mmol / L before and after treatment, (P <0.01). HbA1c was (7.81 ± 1.22)% and (6.42 ± 0.81)% respectively (P <0.05). Insulin and C-peptide measurements after treatment showed a significant improvement in islet function. Conclusion Glargine and repaglinide can simulate physiological insulin secretion, effectively control blood sugar, improve β-cell function and be safe to use.