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目的分析甘精胰岛素联合阿卡波糖对2型糖尿病患者胰岛功能和血糖波动的影响。方法选取梧州市红十字会医院收治的2型糖尿病患者100例进行试验,均于2015年3月—2016年11月间收治的患者。将所有患者随机分为对照组与研究组,每组50例。两组患者均予以常规饮食疗法和运动疗法进行治疗,对照组患者使用预混人胰岛素治疗,研究组患者使用甘精胰岛素联合阿卡波糖治疗,两组患者均连续治疗12周。比较两组患者治疗前后日最大血糖波动幅度(LAGE)、餐后血糖波动幅度(PPGE)、空腹血糖变异系数(CV-FPG)、胰岛素抵抗指数(Homa-IR)、胰岛素分泌指数(Homa-β)及不良反应发生情况。结果治疗前,两组患者LAGE、PPCE(早、中、晚)、CV-FPG情况比较,差异无统计学意义(P>0.05);治疗后研究组患者LAGE、PPCE(早、中、晚)、CVFPG低于对照组(P<0.05);治疗后两组患者LAGE、PPCE(早、中、晚)、CV-FPG低于治疗前(P<0.05)。治疗前两组患者Homa-IR、Homa-β水平比较,差异无统计学意义(P<0.05);治疗后两组患者Homa-IR低于治疗前,Homa-β高于治疗前(P<0.05),研究组患者Homa-IR低于对照组,Homa-β高于对照组(P<0.05)。研究组患者低血糖发生率低于对照组(P<0.05)。结论对于2型糖尿病患者,选择甘精胰岛素联合阿卡波糖进行治疗,对于改善患者胰岛功能有重要作用,平缓血糖波动,降低低血糖发生率。
Objective To analyze the effects of glargine plus acarbose on pancreatic islet function and blood glucose fluctuation in type 2 diabetic patients. Methods 100 cases of type 2 diabetes patients admitted to Wuzhou Red Cross Hospital were enrolled in this study. All patients were treated in March 2015-November 2016. All patients were randomly divided into control group and study group, 50 cases in each group. Both groups were treated with conventional diet and exercise therapy. Patients in the control group received pre-insulin therapy. Patients in the study group were treated with insulin glargine and acarbose for 12 weeks. The levels of maximum blood glucose (LAGE), postprandial blood glucose fluctuation (PPGE), fasting blood glucose (CV) -FPG, Homa-IR and Homa-β were compared between the two groups before and after treatment ) And adverse reactions occurred. Results Before treatment, there was no significant difference in LAGE, PPCE (early, middle and late) and CV-FPG between the two groups (P> 0.05) (P <0.05). After treatment, the levels of CV-FPG in LAGE and PPCE (early, middle and late) in both groups were lower than those before treatment (P <0.05). There was no significant difference in Homa-IR and Homa-β levels between the two groups before treatment (P <0.05); Homa-IR was lower in both groups after treatment than before treatment (P <0.05) ), Homa-IR in study group was lower than that in control group, and Homa-β was higher than that in control group (P <0.05). The incidence of hypoglycemia in study group was lower than that in control group (P <0.05). Conclusion In patients with type 2 diabetes, the choice of insulin glargine combined with acarbose for the treatment of pancreatic islet function in patients with an important role in the smooth fluctuations in blood sugar, reduce the incidence of hypoglycemia.