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目的比较睡前甘精胰岛素(IG)和中性鱼蛋白锌胰岛素(NPN)皮下注射联合格列齐特缓释片治疗2型糖尿病伴磺脲类药物继发失效患者的效果。方法选择47例的磺脲类药物继发失效的2型糖尿病患者,随机分成2组,予格列齐特缓释片联合睡前甘精胰岛素(24例)或中性鱼蛋白锌胰岛素(23例)16周,观察空腹血糖、餐后2h血糖、糖化血红蛋白、体重指数、C肽治疗前后变化的情况。结果与治疗前相比,血糖(空腹及餐后2h)、糖化血红蛋白、明显下降(P<0.05);体重指数无明显变化(P>0.05),NPN治疗后C肽变化不大,应用IG治疗后C肽升高。结论格列齐特缓释片联合睡前甘精胰岛素及中性鱼蛋白锌胰岛素治疗2型糖尿病伴磺脲类药物继发性失效均有效,但甘精胰岛素组低血糖较少,且治疗后C肽升高,故甘精胰岛素组有更好的疗效。
Objective To compare the efficacy of gliclazide (IG) and neutrophil zinc insulin (NPN) administered subcutaneously in combination with gliclazide sustained-release tablets in the treatment of type 2 diabetes with secondary failure of sulfonylureas. Methods Forty-seven patients with type 2 diabetes mellitus secondary to failure of sulfonylurea were randomly divided into 2 groups. Gliclazide extended-release tablets combined with glargine (24 cases) or neutrophil zinc insulin (23 cases) Cases) for 16 weeks to observe the changes of fasting blood glucose, 2h postprandial blood glucose, glycosylated hemoglobin, body mass index and C peptide before and after treatment. Results Compared with those before treatment, blood glucose (fasting and postprandial 2h), HbA1c significantly decreased (P <0.05), while body mass index had no significant change (P> 0.05) Post C peptide increased. Conclusion Gliclazide sustained-release tablets combined with bedtime glargine and neutrophil zinc insulin are effective in treating secondary failure of type 2 diabetes mellitus with sulfonylureas, but there is less hypoglycemia in glargine group, and after treatment C peptide increased, so insulin glargine group has a better effect.