【摘要】 目的:观察甘精胰岛素联合吡格列酮及阿卡波糖治疗初诊2型糖尿病的降糖效果及对胰岛素抵抗和β细胞功能的影响。方法:30例初诊2型糖尿病患者应用甘精胰岛素每日一次注射,联合口服吡格列酮及阿卡波糖4周,4周后停药继续观察半年,分别于治疗前后测身高、体重、三酰甘油、空腹血糖(FPG)、空腹胰岛素(FINS)、空腹C肽(FCP)、糖化血红蛋白(HbA1c)、餐后2h血糖(2hPG)、2h胰岛素(2hINS)、2hC肽(2hCP),计算体重指数、胰岛素抵抗指数(HOMA-IR)、β细胞功能指数(HOMA-b)。结果:治疗4周时血糖基本恢复正常,HbA1c明显下降,空腹及餐后2h胰岛素、C肽以及HOMA-β明显升高,HOMA-IR明显下降,三酰甘油明显改善,体重指数无明显变化。随访半年时,80%患者血糖维持在正常范围,20%血糖升高者多数仅需增敏剂或/及葡萄糖糖苷酶抑制剂即可满意控制血糖。结论:甘精胰岛素联合吡格列酮及阿卡波糖可迅速控制初诊2型糖尿病患者的血糖,恢复β细胞功能,降低胰岛素抵抗,使血糖长期稳定在较好水平。更多还原

【Abstract】 Objective:To determine the therapeutic effects of glargine combined with pioglitazone and acarbose in type 2 diabetic patients.Methods:Thirty patients of newly diagnosed type 2 diabetes mellitus were treated by glargine combined with pioglitazone and acarbose for 4 weeks,then followed-up for six months.Height,weight,plasma triglyceride,fasting plasma glucose,fasting insulin,fasting C peptide,HbA1C,2 h plasma glucose,2 h insulin,2 h C peptide were measured before and after treatments,and BMI,HOMA-IR and HOMA-β were calculated.Results:After 4 week treatments,the plasma glucose level recovered to the normal range;HbA1C and HOMA-IR were significantly decreased;fasting and 2 h insulin,C peptide and HOMA-β were significantly increased;plasma triglyceride was obviously improved.However,BMI did not obviously change.Followed-up for 6 months,80% patients maintained the normal plasma glucose level,while 20% patients had a slightly elevated blood glucose level that might return to the normal level by treatment with pioglitazone or/and acarbose.Conclusion:Glargine in combination with pioglitazone and acarbose can quickly control blood glucose,recover β cell function,decrease insulin resistance,and keep plasma glucose at a satisfactory level for a long time.更多还原