韩丽丽

摘要：目的  觀察甘精胰岛素与格列美脲联合治疗口服降糖药控制不佳2型糖尿病的疗效。方法  选择2018年6月～2019年3月在我院诊治的90例口服降糖药控制不佳2型糖尿病患者作为研究对象，随机分为对照组和观察组，各45例，对照组采用格列美脲治疗，观察组在对照组基础上联合甘精胰岛素治疗，对比两组临床治疗疗效、空腹血糖（FPG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbA1c）水平以及低血糖发生情况。结果  治疗后，观察组治疗总有效率（93.33%）与对照组治疗总有效率（91.11%）比较，差异无统计学意义（P>0.05）。治疗后两组FPG、2hPG、HbA1c水平均较治疗前降低，差异有统计学意义（P<0.05）;观察组FPG、2hPG与对照组比较，差异无统计学意义（P>0.05）;观察组HbA1c与对照组比较，差异有统计学意义（P<0.05）;观察组低血糖发生率（17.78%）低于对照组（35.56%），差异有统计学意义（P<0.05）。结论  口服降糖药控制不佳2型糖尿病患者采用甘精胰岛素联合格列美脲治疗疗效理想，且可降低治疗期间低血糖发生率，安全性高，值得临床应用。

关键词：甘精胰岛素;格列美脲;2型糖尿病

中图分类号：R587.1                                  文献标识码：A                                DOI：10.3969/j.issn.1006-1959.2019.18.050

文章编号：1006-1959（2019）18-0146-03

Abstract：Objective  To observe the efficacy of insulin glargine combined with glimepiride in the treatment of poorly controlled type 2 diabetes mellitus with oral hypoglycemic agents. Methods  90 patients with poor control of type 2 diabetes mellitus who were treated with oral hypoglycemic agents in our hospital from June 2018 to March 2019 were randomly divided into control group and observation group， 45 cases in each group. After urea treatment， the observation group was treated with insulin glargine on the basis of the control group. The clinical treatment efficacy， fasting blood glucose （FPG）， postprandial 2h blood glucose （2hPG）， glycosylated hemoglobin （HbA1c） level and hypoglycemia were observed.Results  After treatment， the total effective rate of the observation group （93.33%） was compared with the total effective rate of the control group （91.11%），the difference was not statistically significant （P>0.05）. After treatment， the levels of FPG， 2hPG and HbA1c in the two groups were lower than those before treatment，the difference was statistically significant （P<0.05）. There was no significant difference between the observation group FPG and 2hPG and the control group （P>0.05）.Compared with the control group， the difference of HbA1c in the observation group was statistically significant （P<0.05）.The incidence of hypoglycemia in the observation group was（17.78%） lower than that in the control group（ 35.56%），the difference was statistically significant （P<0.05）.Conclusion  Oral hypoglycemic agents have poor control of type 2 diabetes patients. The combination of insulin glargine and glimepiride is effective， and can reduce the incidence of hypoglycemia during treatment. It has high clinical safety and has important clinical application.

Key words：Insulin glargine;Glimepiride;Type 2 diabetes

随着人们生活水平的提高，饮食结构发生改变，2型糖尿病发生率明显上升，严重影响人们的身体健康和生活质量[1]。糖尿病属于一种慢性病，以高血糖为主要特征，通常伴有因胰岛素分泌缺陷引起的糖、脂肪、蛋白质代谢异常。2型糖尿病与胰岛素抵抗、胰岛素分泌不足相关，临床通常采用口服降糖药、控制饮食等治疗，但是效果不理想[2]。本研究结合2018年6月～2019年3月在我院诊治的90例口服降糖药控制不佳2型糖尿病患者临床资料，观察甘精胰岛素联合格列美脲治疗口服降糖药控制不佳2型糖尿病的疗效，为临床治疗提供新的方向，现报告如下。

1资料与方法

1.1一般资料  选取2018年6月～2019年3月在首都医科大学石景山教学医院诊治的90例口服降糖药控制不佳2型糖尿病患者作为研究对象，将其按照随机数字表法分为对照组和观察组，每组45例。对照……