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目的观察米格列奈与瑞格列奈分别联合二甲双胍治疗新诊断2型糖尿病(T2DM)的临床效果。方法选取2011年2月-2012年3月新诊断的T2DM患者80例,随机分为米格列奈组与瑞格列奈组各40例。2组患者在餐前8min左右均服用二甲双胍500mg,每天2次。米格列奈组给予米格列奈10mg口服,3次/d;瑞格列奈组在服用二甲双胍的同时给予瑞格列奈1mg口服。治疗过程中使用动态的血糖监测系统对患者12周治疗期内的血糖动态水平及胰岛素变化详情进行记录,治疗后为患者制定随访计划定期随访。结果药物治疗12周后2组FBG与PBG水平与治疗前相比明显降低,FINS水平与治疗前相比明显升高,差异均有统计学意义(P<0.05)。2组治疗后FBG、PBG、FINS水平比较差异无统计学意义(P>0.05)。米格列奈组低血糖发生率为30%(12/40)高于瑞格列奈组的50%(20/40),差异有统计学意义(P<0.05)。2组患者经调整药物摄入剂量后症状均得以减轻。结论 2组均能使新诊断的T2DM患者血糖得到较好控制,血糖水平有所降低,疗效相当。但米格列奈和瑞格列奈相比,患者低血糖的发生率较低,效果更好。
Objective To observe the clinical effect of mitiglinide and repaglinide combined with metformin in newly diagnosed type 2 diabetes mellitus (T2DM). Methods Eighty newly diagnosed T2DM patients from February 2011 to March 2012 were selected and randomly divided into two groups: 40 cases in the mitiglinide group and 25 cases in the repaglinide group. Patients in both groups took metformin 500 mg at about 8 minutes before meals twice a day. The mitiglinide group was given 10 mg of mitoxantrone orally 3 times a day. The repaglinide group was administered with 1 mg of repaglinide while taking metformin. The course of treatment using dynamic glucose monitoring system during the 12-week treatment of patients with blood glucose levels and changes in insulin details recorded after treatment follow-up plan for patients to develop regular follow-up. Results After 12 weeks of treatment, the level of FBG and PBG in two groups was significantly lower than that before treatment, and the level of FINS was significantly higher than that before treatment (P <0.05). There was no significant difference in FBG, PBG and FINS between the two groups (P> 0.05). The incidence of hypoglycemia in the mitiglinide group was significantly higher than that in the repaglinide group (30% vs 12/40) (20/40) (P <0.05). Symptoms were relieved in both groups after adjustment for medication intake. Conclusion Both groups can make the newly diagnosed T2DM patients get better control of blood glucose, blood glucose levels decreased, with comparable efficacy. However, compared with repaglinide, the incidence of hypoglycemia is lower and the effect is better.