甘精胰岛素与阿卡波糖分别联合二甲双胍对2型糖尿病患者长期血糖控制对比分析

中国药物警戒 ›› 2018, Vol. 15 ›› Issue (12): 709-712.

甘精胰岛素与阿卡波糖分别联合二甲双胍对2型糖尿病患者长期血糖控制对比分析

戚仁娟, 撒小军, 宋洁, 张永明

安徽省第二人民医院内分泌科,安徽合肥 230000

收稿日期:2019-01-18 修回日期:2019-01-18 出版日期:2018-12-20 发布日期:2019-01-18
作者简介:戚仁娟,女,住院医师,糖尿病与甲亢。

Comparative Analysis of Long-term Glycemic Control in Patients with Type 2 Diabetes Mellitus Treated with Insulin Glargine and Acarbose Combined with Metformin

QI Renjuan, SA Xiaojun, SONG Jie, ZHANG Yongming

Endocrinology Department, Anhui NO.2 Provincial People's Hospital, Anhui Hefei 230000, China

Received:2019-01-18 Revised:2019-01-18 Online:2018-12-20 Published:2019-01-18

摘要/Abstract

摘要： 目的评价甘精胰岛素与阿卡波糖分别联合二甲双胍对2型糖尿病患者长期血糖控制的效果。方法 86例2型糖尿病患者随机分为对照组（二甲双胍联合阿卡波糖）、研究组（二甲双胍联合甘精胰岛素）,各43例。比较不同组别患者治疗前、治疗6个月后、12个月后两组血糖指标（FBG、2 h PBG、HbAlc）、氧化应激指标（MDA、SOD、GSH-PX）、血脂代谢指标（TC、TG、LDL-C）、血糖达标率及不良反应发生率。结果治疗6个月后、12个月后,研究组血糖指标FBG、2 h PBG、HbAlc水平均低于对照组（P <0.05）;氧化应激指标SOD、GSH-PX水平明显高于对照组,MDA水平明显低于对照组（P <0.05）;两组间血糖达标率及不良反应发生率比较无统计学意义（P >0.05）。结论二甲双胍联合甘精胰岛素治疗2型糖尿病的疗效确切,具有更好的长期预后。

关键词: 二甲双胍, 甘精胰岛素, 阿卡波糖, 2型糖尿病, 长期血糖控制

Abstract: Objective To evaluate the effect of insulin glargine and acarbose combined with metformin on long-term glycemic control in patients with type 2 diabetes. Methods 86 patients with type 2 diabetes were divided into control group (metformin combined with acarbose) and the research group (metformin combined with insulin glargine) randomly, 43 cases each. Blood glucose levels (FBG, 2 h PBG, HbAlc), oxidative stress (MDA, SOD, GSH-PX), and lipid metabolism indicators(TC, TG, LDL-C), blood glucose compliance rate and incidence of adverse reactions were compared between the two groups before treatment, 6 months after treatment, and 12 months after treatment. Results After 6 months and 12 months of treatment, the blood glucose levels of FBG, 2 h PBG and HbAlc in the study group were lower than those in the control group (P <0.05); the levels of SOD and GSH-PX were significantly higher than those in the control group; the level of MDA was significantly lower than that of the control group (P <0.05); and the blood glucose standard-reaching rate and the incidence of adverse reactions were not statistically significant (P >0.05). Conclusion Metformin combined with insulin glargine is effective in the treatment of type 2 diabetes with a better long-term prognosis Keywords: metformin; insulin glargine; acarbose; type 2 diabetes; long-term glycemic control

中图分类号:

R969.4

戚仁娟, 撒小军, 宋洁, 张永明. 甘精胰岛素与阿卡波糖分别联合二甲双胍对2型糖尿病患者长期血糖控制对比分析[J]. 中国药物警戒, 2018, 15(12): 709-712.

QI Renjuan, SA Xiaojun, SONG Jie, ZHANG Yongming. Comparative Analysis of Long-term Glycemic Control in Patients with Type 2 Diabetes Mellitus Treated with Insulin Glargine and Acarbose Combined with Metformin[J]. Chinese Journal of Pharmacovigilance, 2018, 15(12): 709-712.

参考文献

[1] 李琼,李一梅,谢波,等.阿卡波糖与二甲双胍治疗糖尿病前期疗效的Meta分析[J].中国全科医学,2015,18(3):304-311.
[2] Su B, Liu H, Li J, et al.Acarbose treatment affects the serum levels of inflammatory cytokines and the gut content of bifidobacteria in Chinese patients with type 2 diabetes mellitus[J]. J Diabetes, 2015,7(5): 729-739.
[3] 龙艳,苏珂,彭鹰,等.血糖波动与氧化应激对2型糖尿病微血管病变的影响[J].中华老年心脑血管病杂志,2014,16(2):147-150.
[4] 秦健,王秀萍,张娜,等.甘精胰岛素联合阿卡波糖治疗注射预混胰岛素血糖控制不佳的2型糖尿病患者有效性和安全性的观察[J].中国糖尿病杂志,2014,22(5):439-441.
[5] 吴让兵,王华,杜小梅,等.甘精胰岛素结合阿卡波糖治疗对老年糖尿病患者糖化血红蛋白和空腹C肽水平的影响[J].中国老年学杂志,2018,38(6):1281-1283.
[6] Meier J J, Schenker N, Kahle M, et al.Impact of insulin glargine and lixisenatide on β-cell function in patients with type 2 diabetes mellitus: A randomized open-label study[J]. Diabetes Obes Metab, 2017,19(11): 1625-1629.
[7] 刘金刚,郑成竹,王勇.中国肥胖和2型糖尿病外科治疗指南(2014)[J].中国实用外科杂志,2014,34(11):1005-1010.
[8] Thapa R, Sharma S, Jeevanantham V, et al.Disparities in lipid control and statin drug use among diabetics with noncoronary atherosclerotic vascular disease vs those with coronary artery disease[J]. J Clin Lipidol, 2015, 9(2): 241-246.
[9] 黎克江,雷永红,刘新华.甘精胰岛素联合二甲双胍治疗2型糖尿病的疗效[J].江苏医药, 2014,40(2):183-185.
[10] 庞宁,陈科,彭皓均,等.阿卡波糖联合二甲双胍对2型糖尿病患者相关指标的影响[J].中国药房,2017,28(27):3774-3777.
[11] 侯丽萍,赵红玲,张雪坤.米格列醇和阿卡波糖分别联合二甲双胍对老年2型糖尿病患者疗效对比[J].中国老年学杂志,2017,37(1):207-208.
[12] Dalmas E, Venteclef N, Caer C, et al.T Cell-derived IL-22 amplifies IL-1β-driven inflammation in human adipose tissue: relevance to obesity and type 2 diabetes[J]. Diabetes,2014,63(6): 1966-1977.
[13] Khangura K K, Eirin A, Kane G C, et al.Extrarenal atherosclerotic disease blunts renal recovery in patients with renovascular hypertension[J]. J Hypertens,2014,32(6): 1300-1306.
[14] 刘福平,张星光,陈彬.二甲双胍联合西格列汀或格列美脲对2型糖尿病血糖波动和氧化应激的影响[J].中国现代医学杂志,2015,25(33):71-74.
[15] Mocarski M, Yeaw J, Divino V, et al.Slow Titration and Delayed Intensification of Basal Insulin Among Patients with Type 2 Diabetes[J]. J Manag Care Spec Pharm, 2018, 24(4):390-400.